Discussion

The aims of this lecture are to:
- Review the pathology present in the arthritic joint and correlate with the generation of pain
- Review the current techniques used in the investigation of arthritic pain in the horse
- Evaluate the usefulness of these techniques in providing a secure diagnosis
- Critically review the requirement of advanced diagnostic imaging techniques in the arthritic horse
- Discuss the economic impact of recent advances in the diagnosis and management of equine arthritis

In recent years equine orthopaedic diagnostic imaging has developed beyond recognition. It is true to say that MRI and scintigraphy have improved our ability to diagnose and prognosticate on a wide range of orthopaedic conditions. Many practices and academic institutions have invested heavily both in terms of capital expenditure and staff costs into the provision of these services. Now we have to ask our clients to pay for this. What happens if they can't or won't? For many equine clients it is an economic fact that while the utilisation of advanced diagnostic techniques may provide the 'gold standard' in service and diagnostic certainty they are too expensive. In the present economic climate the diagnostic work up may cost in excess of the monetary value of the horse.
This lecture discusses the collation of information provided from multiple 'traditional' investigative techniques (clinical examination, diagnostic regional anaesthesia, synoviocentesis, radiography, ultrasonography) as a possible alternative approach to advanced imaging when the owner has budget constraints. The challenges presented by these techniques and their limitations will be discussed with particular reference to the generation of pain from an arthritic joint.
Of course economic restraints also apply when considering the management of equine arthritis. This can be particularly problematic when clients realise that as clinicians we are unlikely to be able to cure the condition and that therapy may be required for a number of years. A brief discussion will be presented of the integration of intra-articular medication with systemic treatment and conservative management.