'Fashionable diseases?'

[steffielu]

Hi all. Hope this doesn't come across as controversial!

Have been looking at some of the threads recently regarding various musculoskeletal disorders and just am commenting on a few observations... Why is it that recently SO MANY horses are being diagnosed with having ''sacroiliac'' problems? Just seems that every post I read, if the horse is unsound or uncomfortable, the sacroiliac is pointed at. I know from my studies on humans that it a very complex joint, shaped for stability rather than mobility, but does have a few degress of movement to enable force transmission from the limb up into the spine. Testing this joint is highly controverial in humans, involving various stress tests which must reproduce the same symptoms. It is unusual to find the key problem lying in this joint. There are also numerous ligaments that add stablity, and many muscles crossing the joint which of course could affect how it expresses movement.

I am wondering how the SI therefore in horses is diagnosed? What testing is used, or is diagnosis symptom based?
I know that a lot of horses have their SI's imaged, and if any anomalies are found its 'Bingo!' However, don't forget that image findings are just that; Findings, not a diagnosis. Also, in humans it is well known that if an area in the body is imaged, such as the rotator cuff muscles in the shoulder, damage will be seen in a large % of people. However, the patient does not report any pain. Also, the majority of the older population will have x-ray changes in their lumbar spine, and degeneration of the discs, which would show up on imaging, however they have no symptoms. Just because something shows up on imaging doesn't mean it is causing the problem!!!!
No one seems to be interested in WHY is the SI a problem, and what part of it is causing the symptoms - what has caused its dysfunction be it poor shoeing, poor management, bad teeth, bad tack; its a case of box rest, throw in some steroid jabs and fingers crossed.
Is it a case of new technology is being developed which is showing up things that have not been able to be assessed before, or is it that in recent years SI problems have become more prevalent? A few years ago, it seemed every lame horse had Navicular. Now its SI problems....what will it be next??!!!

 

[Hoppa]

Oohh.. contraversial! LOL.

I would suggest the prevalence of diagnosing navicular was brought about by changes in diagnosis methods.. i.e. greater use of MRI and other scans, which weren't available on insurance before, so vets didn't use them as much.

My lad has a suspected Sacroilliac injury (old), vets opinion based on the following:-
He had a rotated pelvis (yes this does actually happen... the ligaments which hold the pelvis in place are weakened/ damaged and therefore one side sits lower than the other, very visible to the eye, causing hind feet to drag, muscle wastage in quarters etc.)
Treatment was few sessions with McTimmony chiropractor, with noticeable benefit after first session, including pelvis levelling and much looser behind. Combined with gentle riding in an outline and ground work to build up quarters and strenghten his back.
Also he displays the classic "jumpers bump". Which is greatly misunderstood. Jumpers bump is not a conformation type, horses are not born with it. It develops becasue the structures in the sacroiallac area change in line with too much jumping, usually at too young an age. Or you often see it hunters, for same reason. This is why some people who are looking for a jumping horse, think that this is a type of conformation, which means they are good jumpers... when in fact its the reverse. As you say this area is difficult and expensive to scan/ x-ray so I guess vets refer to problems in the sacroilliac "area"

I think not only has there been changes in technology, increased insurance cover etc in the past 15 years, but also changes in thinking. People want their horses to be more comfortable and are willing to pay. I remember the days when one saddle fitted all... your horse had to go to the hospital and be knocked out for an x-ray.. if you could afford it! Would also imagine that horses are probably living longer now?

There is new technology coming to the mainstream all the time, I've seen thermal imaging recently, no doubt it helps us better understand the nature of problems?