Most lameness in horses is due to issues with the feet, but some lameness can originate from the hip and pelvic area. Dr. Thomas Daniel Jr., DVM, writes in The Horse that many hip and pelvic issues are underdiagnosed in performance horses. 

Dr. Daniel says inflammation is seen at and around the sacroiliac joint. It has been shown that the pelvis is overlooked partly because problems in this area are difficult to diagnose, as we can better image the other joints. 

In the past, we had only X-rays, and taking X-rays of a horse’s pelvis is difficult because of their size, and the process requires general anesthesia. We now have better diagnostic tools.

Ultrasound is readily available to most equine practitioners and can be helpful in determining the size of ligaments in the horse’s hip and pelvis, but nuclear scintigraphy (bone scan) is much more effective.

This test involves injecting the horse with a radioactive material. The sedated horse is scanned with a gamma camera. Areas of increased radioactive uptake show up as hot spots and show areas of bone remodeling.

The four main conditions affecting the horse’s pelvis include fracture or dislocation of the pelvis, sacroiliac strain, or osteoarthritis. Dr. Robin Dabareiner, DVM, DACVS, PLLC , from Caldwell, Texas, says many of these conditions require extended rest for several months. Anti-inflammatories can also be used, and corticosteroid injections can be performed in the sacroiliac joint. 

Previously, these joints were difficult to inject, but the injections are now more accurate due to the ability to see the needle entering the joint using ultrasound. Horses with pelvic injuries often require months of physical therapy to return to their former level of performance, but recovery times vary based on the individual horse and the injury they suffered.

Your veterinarian is your best resource for advice and treatment information if your horse has a lameness issue.