What is Ringbone?

Q: My 17-year-old Arab gelding has been diagnosed with ringbone. His granddam and another of her offspring also had this disease. What exactly is ringbone? Is it hereditary? What is its cause? My veterinarian has done an exam and X rays and recommended Bute (phenylbutazone) and regular exercise.      Dana

A: Ringbone, a lameness disease of the pastern and coffin joints, is a degenerative disorder that has no cure. Once the condition occurs, it's always there and will progressively worsen. Fortunately, with treatment and good management, the disease's progression can be slowed, allowing the horse to remain competitive.

Ringbone causes a circumferential enlargement at the level of the joint. High ringbone refers to the pastern joint and low ringbone refers to the coffin joint. The disease is similar to arthritis, with the affected area showing bone spur formation (additional bone buildup) and degenerative joint disease.

Articular ringbone (affecting the joint surface) affects the cartilage and synovium (joint lining), resulting in enlargement, pain, and stiffness of the joint. Periarticular (near the joint) ringbone affects the soft structures near the joint, such as ligaments and joint capsules. These structures, when inflamed by trauma, laceration, or sudden or chronic athletic strain, respond by stimulating bony growth. Poor conformation for the athletic use of the horse can also contribute to ringbone. We find that periarticular ringbone is more common and more serious.

The first sign of ringbone an owner usually sees is lameness that might be intermittent. The tissues around the area might be soft and painful. As the condition progresses, the area becomes firm, cool, and non-painful to touch. In chronic cases, the horse might have swelling around the pastern or on top of the coronary band.

Diagnosis is based on a history of the problem and a lameness examination. Consideration is taken of the external appearance, palpation and manipulation of the joints, and radiographs. Prognosis depends on the severity of the disease at the time of diagnosis, the intensity of the horse's use, and the degree of management. Advanced ringbone cases have a poor prognosis.

The foundation of treatment is rest. Treatment success is related to the cause. Bute might be more helpful in early stages; more aggressive treatments include joint injection with hyaluronic acid, Adequan, and steroids, or a combination of the three. Generally ringbone will progress if the horse is used at the same pace.

Once in a while, changing the angles of the shoes with wedges under the heel will help take pressure off the anterior aspect (front) of the joint. This has improved pain in some horses. Surgical fusion (immobilization) of the pastern joint can be performed if that is the primarily affected joint and serves to eliminate the pain associated with the degenerative process.

About the Author

Justin Edwards, DVM

Justin Edwards, DVM, practices in Estacada, Oregon.

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