With acute synovitis, heat will be more marked, and effusion will palpate harder and more filled. As the condition becomes chronic the heat tends to decrease some and the effusion becomes . In the chronic phase effusion may be less noticeable due to fibrosis and thickening of the joint capsule and the associated tendons and ligaments. Synovial fluid from an affected joint will be watery, and there will be excess fluid within the capsule. Arthroscopic examination of the joint cavity may reveal areas of damage to the articular cartilage and the formation of osteophytes and enthesiophytes. In severe and longstanding chronic cases, exostosis and ankylosis may be seen in joints with little range of motion. Chronic synovitis/capsulitis will lead to arthritis.
Diagnosis is made through clinical signs and symptoms, aspiration and physical examination of synovial fluid, chemical analysis of synovial fluid and radiography.
Treatment depends on the history and age of the horse and on the aims of the owner or trainer. Conservative treatment includes oral/topical NSAID’s (bute/Surpass) and rest. Moderate treatment for synovitis in older horses, or in individuals with articular damage is IA corticosteroids and rest. Moderate treatment for synovitis in individuals without cartilage damage is IA hyaluronic acid, IA Traumeel, IA Adequan or IM Adequan. Aggressive treatment for individuals with cartilage damage includes arthroscopic debridement or induced ankylosis. Other beneficial treatments at any stage include massage therapy, laser therapy, stem cell therapy, Interleukin 1 Receptor Antagonist Protein (IRAP) therapy and the use of therapeutic magnets. Supplements such as chondroitin sulphate, glucosamine and methylsulfonylmethane (MSM) are shown to help in the prevention and reversal of joint disease. It is not clear if these compounds are bioavaliable when supplemented orally.
Common conditions involving synovitis/capsulitis include:
Carpitis
Gonitis
Bog Spavin
Osselets
Degenerative Joint Disease (DJD) Degenerative joint disease (DJD) is described as abnormal wear and degradation of the articular cartilage accompanied by low grade inflammation of a joint.
There are two main forms of DJD:
(OA) &
arthritis (RA).
This chapter will focus on OA as RA was previously discussed in the immunity section.
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