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Villonodular synovitis is caused bychronic traumatic injury to the fetlock, resulting in thickening of the synovial padin the front of the fetlock joint. This is aproblem in racehorses, causing lamenessand joint swelling. With many of these problems, onset canbe gradual or sudden. Says Dechant, \sionally the bursitis or synovitis is associatedwith a specific or recent trauma, and the clinical signs of swelling and/or lameness willsuddenly develop. More frequently, the clinical signs gradually develop over time and aspecific incident or time-point cannot be determined for its development.\While these problems can developacutely, all have the potential to developinto chronic problems. \the problem is chronic,\risk FActors Synovitis and bursitis without lameness commonly develop in two groups ofhorses - young horses entering trainingand mature performance horses. Young horses with conformation problems, such as joints that are too straight ortoo angled, might be predisposed, saysDechant. The condition also can arise inresponse to training demands. Youngracehorses or performance horses tend todevelop cunean bursitis/tarsitis due to thestresses of racing and training. She notesthat young show horses are the ones mostcommonly presented for evaluation ofthese problems because of owner/trainerconcerns about the cosmetic blemish andconcerns for future performance. In mature performance horses, ongoinguse and accompanying wear and tear canresult in mild, chronic swelling of thehocks, digital tendon sheaths and fetlocks.\ing horses may be predisposed to hittingtheir elbows with their hooves duringmovement, causing capped elbows,\Dechant says. \tensions, trailers or calks may traumatizetheir elbows when lying down becausethe modified shoe is more likely to comein contact with the elbow.\DiAGnosis In making the diagnosis, Kramer recommends a veterinary physical exam consistingof an overall physical exam, detailed observation, manipulation and palpation of thelimbs and a lameness exam. If any lamenessis present, diagnostic anesthesia might benecessary to determine if the effusion is thesource of lameness. %underlying joint disease such as osteochondrosis, degenerative joint disease andtraumatic chip fractures,%ultrasound evaluation is used to assesstendon and ligament damage.”\of an underlying disease process such asosteochondrosis, carpal chip fractures,tendon damage within the sheath, etc.,\says Kramer. \check for evidence of a wound that mayhave entered a synovial structure; thismay require distending a joint, tendonsheath, or bursa with sterile saline andlooking for saline leaking out of a nearbywound, providing evidence that part ofthe wound entered the synovial structure.\The synovial fluid might be analyzedfor total white blood cell count, total protein and presence of bacteria. ReportsKramer, \protein levels or the presence of bacteriawould suggest infectious synovitis or bursitis. Elevations in protein only or elevations in protein with mild elevations in redcells or white cells are more suggestive oftraumatic, developmental or other non-infectious causes of synovitis.\Dechant says that ultrasound is usefulfor further assessing tendon injuries anddefining the fluid swelling. \cases, contrast studies using a dye thatshows up on radiographs may be helpfulto assess the problem.\trEAtmEnt AnD ProGnosis When discovered and treated early,bursitis and synovitis can usually be favorably resolved. Says Kramer, \due to osteochondrosis generally yields agood prognosis, but this depends onwhere the primary lesion is and how extensive the lesion is. Infectious synovitis/bursitis must be treated early andaggressively, or extensive and sometimespermanent cartilage and soft tissue damage in the joint sheath or bursa results.”\tenosynovitis and bursitis have poor prognoses,\longed exposure to severe inflammation hasoften caused extensive damage that may notresolve even when the infection is overcome.Well-established infections are much moredifficult and costly to treat than acute infections; over time, in the appropriate environment, bacteria can become functionallywalled off from the systemic circulation,making difficult the penetration of systemicand local antibiotic therapy and even thehorse's own immune cells.\Sudden onset of synovitis or bursitisrelative to a mild strain or demands ofearly training is more likely to have spontaneous resolution of clinical signs; this ismore common in young horses. \wise,\for most types of idiopathic synovitis orbursitis include combinations of drainingthe fluid from the swelling, wrapping theleg, applying DMSO topically to theswelling, as well as intra-synovial or intrabursal injections of corticosteroids andhyaluronic acid. If the swelling respondspoorly to injections of corticosteroids and38 Arizona Horse Connection May, 2026SANTORI RANCH• BOARDING • LESSONS • IRRIGATED PASTURES• HORSE CAMPS • ARENA RENTALTrainers on SiteSpecializing in lessons for all ages and abilities.Beginner to the show ring! Seasonedschool horses and leases available.955 W. Road 2 North Chino Valley, AZ(928) 848-3659 Santori-Ranch.comJoin Us For Our Horse Camps In June -week of 6/1 and 6/8!There’s still a few spots open!continued on page 40