radiographs | Horse Racing Free Tips

Fetlock Joint Radiographs Required at Oaklawn for Repeated Intra-Articular Injections

The pilot program currently in place at Oaklawn Park under which veterinarians administer any intra-articular corticosteroid injections at the racetrack in a designated area and in the presence of Oaklawn's integrity department has an addendum: any repeated intra-articular corticosteroid injection to the fetlock joint will now require the attending veterinarian to perform a radiograph. The original program was in association with the Horseracing Integrity and Safety Authority (HISA) and began Dec. 8 along with the track's 2023-24 race season. The new rule will be in place beginning Jan. 25, is in partnership with the Arkansas Horsemen's Benevolent and Protective Association (HBPA), and is in consultation with the Grayson Jockey Club, according to a Wednesday afternoon release from Oaklawn.

Oaklawn's statement said, in part: “Studies have shown the fetlock joint contributes to a larger portion of equine injuries and this rule will give veterinarians more tools to diagnose potential injuries. If the connections believe a Covered Horse should have an intra-articular corticosteroid injection of a fetlock joint within 60 days of a previous injection, the connections are required to have specific digital imaging (radiographs) taken by the attending veterinarian. The attending veterinarian will then assess the fetlock joint radiograph for potentially dangerous findings before the repeated injection is administered.”

Oaklawn, in partnership with the Arkansas HBPA, will pay up to $250 for each required set of radiographs to assist with the costs. The program will continue through May 4, when the current Oaklawn meet draws to a close.

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Letter to the Editor: Radiographs

As we approach the beginning of the Thoroughbred yearling sales season, it is worth reflecting on the process used by buyers to select their racing and sales prospects. Part of the process includes veterinary scrutiny of the radiographs of yearling's' joints. Veterinarians review the radiographs, note any abnormal findings, and then are called upon to assign a level of risk for racing and / or resale that the findings may represent. Another layer of due diligence in recent years has been ultrasound examination of horses' limbs for soft tissue abnormalities, in this case the suspensory branches relative to any sesamoid changes seen in the X-rays. The veterinary opinions are often based upon personal experience, because there is little research to help understand the findings. This has historically resulted in a wide range of opinions on radiographic findings, confusion in the marketplace, and often an unfair and overcritical evaluation of racing and sales prospects.

In an attempt to address the lack of important data and the resulting negative consequences to the Thoroughbred racing and breeding industry, several studies have recently been completed looking at stifle and sesamoid radiographs as well as suspensory branch ultrasound findings in sales horses. Initiated by clinician scientists at the Orthopaedic Research Center at Colorado State University, these studies started with evaluation of the radiographs of 2,508 yearlings and suspensory branch ultrasound exams of 593 yearlings at the 2016 Keeneland September Sale. The next step was to evaluate any horses from the initial group that went to the 2017 2-year-olds in training sales to study the progression or regression of the findings. The final portion of the research was to study racing outcomes through the end of the horses' 4-year-old racing season to see what effect the radiographic and ultrasonographic findings had on their performance as racehorses.

The results of the studies are encouraging, demonstrating that the presence of certain findings does not necessarily have a negative effect on suitability for racing. Another element of these studies that can benefit industry stakeholders is a recommendation to use consistent descriptions of the findings, creating uniformity in messaging of the findings and thereby helping veterinarians communicate accurate risk assessments to their clients.

The importance of this research to the Thoroughbred racing and breeding community cannot be underestimated, and there will be a significant effort to ensure that the information is accessible to everyone. One such offering will be a presentation of the research findings at the Fasig-Tipton sales grounds, the afternoon prior to the start of the July Sale on Sunday, July 9, at 4:30 p.m. Drs. Wayne McIlwraith and Chris Kawcak will present a summary of the sesamoid and stifle findings, followed by a moderated panel discussion with sales veterinarians and a Q&A session. All stakeholders in the Thoroughbred racing and breeding industry are encouraged to attend.

—Dr. Jeffrey Berk, Dr. Christopher Kawcak and Dr. Wayne McIlwraith

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Research Study On Diagnostics For Equine Osteoarthritis Of The Neck

Radiographs have been found to be insufficient evidence for diagnosing Cervical Facet disease according to a research study by Dr. Judith Koenig and a team of researchers at the Ontario Veterinary College. In a video interview, Koenig explains some of the complexities of equine osteoarthritis and cervical facet disease.

“Osteoarthritis is common in any athlete,” explains Koenig “especially as they get older.” The development of bone spurs can cause the facets to become enlarged. Inflammation around the cervical facet joints can affect the soft tissues and nerve roots. It is hypothesized that slight neck instability or overuse can result in remodeling of the joint. There were a larger number of dressage horses relative to the hospital population in the study and dressage horses may be at a higher risk for overuse of the facet joints of the cervical vertebrae.

Clinical signs of Osteoarthritis in the neck include: atrophy/muscle wasting (pronounced hollow in lower neck and vertebrae appear prominent), stiff neck (e.g. limited range in carrot stretch, difficulty when ridden in a “frame”) and sometimes front limb lameness that does not resolve by nerve blocking up the leg.

One of the reasons for the OVC study was the fact that previous studies have shown radiographs indicating changes in the neck of younger horses (6 to 8 years old) with no other clinical signs of osteoarthritis. Koenig has seen for herself, horses dismissed after pre-purchase exams when radiographs indicate mild osteoarthritis. When previous studies indicate 50 percent of clinically normal mature horses present with mild osteoarthritis on radiographs, a study to explore the significance was in order.

Differing opinions in classifying the severity of the stage of osteoarthritis from radiographs was revealed to be a good case for not using radiographs alone in diagnosis. “The repeatability of grading of osteoarthritis from radiographs was not reliable,” says Koenig. Two-thirds of the horses in the OVC study that were treated with intra-articular cortisone injection returned to their full level of work. The study concluded that radiographs alone were insufficient to diagnose cervical facet disease and other clinical signs (atrophy, stiffness, or lameness unresolved by nerve block) need to be present.

Watch the Equine Guelph video here.