THE MERCK VETERINARY MANUAL
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Sacroiliac Joint Abnormalities in Horses

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Acute and severe strain of the sacroiliac ligaments is associated with a history of injury and of severe pain in the pelvic or sacro-iliac region, often with marked hindlimb lameness. Subacute or chronic sacroiliac strain and osteoarthrosis of the sacroiliac joint cause typical back soreness. There is often a history of poor performance with an intermittent, often shifting, hindlimb lameness. This may be associated with some restriction in hindlimb action and dragging of the toe of one or both hooves.

A diagnosis of sacroiliac pain and lesions can be made in clinical practice with a combination of physical examination and ultrasonography. The ventral aspect of the sacroiliac can be imaged using a rectal probe. Abnormal ultrasonographic findings seen at the ventral aspect of the sacro-iliac joint in clinical cases include bone modeling of the sacrum and/or ileum, narrowing of the joint space, remodeling or periarticular osteophytes of the caudal border of the auricular surface of the sacrum, remodeling or periarticular osteophytes of the caudal auricular margin of the ileum, periarticular bone fragmentation, and ventral sacroiliac ligament desmopathy and enthesopathy.

Treatment and management include ultrasonographic-guided injections of steroids using cranial and caudal approaches to the joint, mesotherapy over the painful area, and rehabilitation using progressive warmup at a slow canter and exercises that develop the gluteal muscles.

Last full review/revision March 2012 by Stephen B. Adams, DVM, MS, DACVS; Joerg A. Auer, DrMedVet, Dr h c, MS, DACVS, DECVS; James K. Belknap, DVM, PhD, DACVS; Jane C. Boswell, MA, VetMB, CertVA, CertES (Orth), DECVS, MRCVS; Peter Clegg, MA, Vet MB, PhD, CertEO, DECVS, MRCVS; Andrew L. Crawford, BVetMed, CertES (Orth), MRCVS; Jean-Marie Denoix, DVM, PhD, Agregé; Marcus J. Head, BVetMed, MRCVS; C. Wayne McIlwraith, BVSc, PhD, DSc, FRCVS, DACVS, DACVSMR; James Schumacher, DVM, MS, DACVS, MRCVS; John Schumacher, DVM, MS, DACVIM; Roger K. W. Smith, MA, VetMB, PhD, DEO, DECVS, MRCVS; Chris Whitton, BVSc, FACVSc, PhD

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