Acute and severe strain of the sacroiliac ligaments is associated with a history of injury and severe pain in the pelvic or sacroiliac 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 toes of the hindlimb(s).
A diagnosis of sacroiliac pain and lesions can be made in clinical practice with a combination of physical examination and exclusion of other causes of lameness. A demonstration of improvement in gait after local anesthetic infiltration of the sacroiliac joint region is occasionally performed to confirm diagnosis. Ultrasonographic assessment of the ventral aspect of the sacroiliac can be performed using a rectal probe. Abnormal ultrasonographic findings seen at the ventral aspect of the sacroiliac 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 articular surface of the sacrum and caudal articular margin of the ileum, periarticular bone fragmentation, and ventral sacroiliac ligament desmopathy and enthesopathy.
Treatment and management of sacroiliac disease is usually supportive and nonspecific. Therapies include periarticular injections of steroids and rehabilitation using progressive warm-up at a slow canter and exercises that develop the gluteal muscles.