TROCHANTERIC
BURSITIS
(WHORLBONE LAMENESS) IN HORSES
James M. Casey, D.V.M, M.S.
Equine Sports Medicine, Dentistry, & Surgery
Office: (301) 7254371 Cell: (301) 7855167
Website: www.equinehorsevet.com
TROCHANTERIC BURSITIS
(WHORLBONE LAMENESS)
What is Trochanteric Bursitis?
Trochanteric Bursitis (whorlbone
lameness) is soreness and lameness
found in the hind end (back legs) of
horses involving a bursa. A bursa is a
saclike cavity filled with a viscous fluid
and situated at places in the tissues at
which friction would otherwise develop.
Inflammation of a bursa is referred to as
Bursitis. Thoroughbred race horses,
standardbred race horses, steeplechase
horses, and other sport horses often
exhibit lameness that is localized to
inflammation of the Trochanteric Bursa.
This bursa is found in both hind legs, it is
beneath the tendon of the middle gluteal
muscle as it passes over the greater
trochanter of the femur. This area is often
referred to as the whorlbone. There is no whorlbone in horses. This area is
actually the trochanteric bursa.
Why does Trochanteric Bursitis (Whorlbone Lameness) Occur?
The inflammation of the bursa is caused by trauma or by a strain on the gluteal
tendon due to a compensating motion of the limb(s) related to both hock and
stifle lameness. Often horses have lameness in either the hock or stifle, at times
both. Lameness in the hock and/or stifle alters the normal way a horse moves,
which strains the area of the gluteal tendon and the trochanteric bursa
(whorlbone).
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What are the signs?
Pain may be seen when pressure is applied over the greater trochanter. Also,
when observing how the horse places its hind foot on the ground when jogging.
The inside or medial wall of the hoof comes in contact with the ground before the
outside or lateral wall of the hoof touches the ground. In some cases an
examination of the shoes will note the inside of the hind shoe is worn more than
on the outside of the hind shoe.
Diagnosing?
Diagnosis of trochanteric bursitis
(whorlbone lameness) is done by
physical examination and
observation. Diagnostic aids
include Infrared thermography,
which will reveal an increased
thermal gradient (temperature)
directly over the greater trochanter
of the femur. Also, a diagnostic
nerve block using local anesthetic
directly over the bursa will
differentiate this bursitis from other
conditions.
Treatment of Trochanteric Bursitis (Whorlbone Lameness)
The old time remedy was to inject counter irritants
such as iodine into and around the trochanter
bursa. Now, there are more effective treatments
available to replace this procedure. Injection of the
trochanteric bursa with low dose cortical steroids
and hyaluronic acid is a very effective treatment.
This practitioner prefers to use Betamethasone as
the steroid of choice along with a high
molecular weight hyaluronic acid when
injecting the trochanteric bursa. Platelet
Rich Plasma and Stem Cells are also
useful and indicated as an injection
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treatment for trochanteric bursitis (whorlbone lameness). Strict aseptic technique
should always be used when injecting the trochanteric bursa.
Topical application of medical grade DMSO and cortisone (a capsaicin based
product preferred) massaged around the area of the trochanteric bursa will aid in
the reduction of inflammation and pain.
Remember, soreness in the trochanteric bursa (whorlbone) is usually secondary
to lameness in the hocks and stifles. When treating trochanteric bursitis
(whorlbone lameness) the contributing factors, including soreness in the hocks
and/or stifles, need to be addressed.
Managing Trochanteric Bursitis (Whorlbone Lameness)
In most cases of trochanteric bursitis, the horse will respond to therapy within a
few weeks. However, when training is resumed, constant physical therapy and
maintenance injections of cortical steroids and hyaluronic acid may be needed.
Equine Sports Medicine, Dentistry, & Surgery
James M. Casey, D.V.M, M.S.
Veterinary Practitioner and Surgeon
Practicing in the MidAtlantic States & Florida
(MD, VA, DE, PA, NJ, GA, KY, FL)
Consults Nationally and Worldwide
Office: 3017254371 Cell: 3017855167
Email: [email protected] Website: www.equinehorsevet.com
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