Terry Swanson, DVM, and Rich Redding, DVM, MS, PhD, moderated a table topic, "Hind Limb Lameness, A Pain on the Rear," held during the 2008 American Association of Equine Practitioners convention, which took place Dec. 6-10 in San Diego, Calif. The attendees actively participated in the discussion, asking questions and providing comments.

Those in attendance discussed history and clinical examination of many typical hind limb lamenesses. They noted that once the decision to perform diagnostic analgesia (nerve blocks) or treatment is made, the concern for safety should be foremost in the clinician's mind and appropriate restraint is critical.

The sequence of diagnostic nerve blocks utilized in the hind limb was discussed, including the approach to block the lower limb, followed by intra-articular analgesia of the distal intertarsal and tarsometarsal joint (lower hock joints) for distal tarsal disease.

The routine use of corticosteroids in the treatment of distal tarsal disease was discussed at length, in particular the moderator's choices for triamcinolone over methylprednisolone. The group also discussed the diagnostic approach to a horse with stifle disease