The Work Up and Therapeutic Challenge of Lameness in the Shoulder Area

Lameness associated with the shoulder region is not as common as distal limb lameness. Shoulder pain associated with the swing phase generally results in a shorter stride to minimize shoulder extension and flexion. Horse with shoulder lameness are more lame when the affected leg is at the outside of a circle. Diagnosis of shoulder lameness can be challenging because mild lameness may be difficult to localize. Muscle atrophy at the shoulder region is a typical finding.

Intra-articular analgesia of the shoulder joint usually improves the lameness but rarely alleviates it. 20 ml of anaesthetic solution has to be used, in some horses there is a communication with the bicipital bursa. Rarely an instability of the shoulder appears after applying the block.
The bicipital bursa is large so needs also 20 ml of anaesthetic solution. [...]