Clinical progress in the diagnosis of thoracolumbar problems in horses

It is well known that a painful back can be responsible for loss of performance in horses. Veterinary examination of the sore back used to be limited to manual palpation with diagnosis confirmed empirically by response to treatment. Today, due to advances in imaging, there are multiple methods for evaluating the pathology of the horse's thoracolumbar (TL) spine. Radiography, ultrasonography, nuclear scintigraphy, thermography and algometry all play a part in developing a better understanding of equine TL problems. Despite this progress, definitive diagnosis can still be problematic. There is a lack of objectivity in understanding the implications of the pathology detected and its effect on the horse. It is difficult to determine the degree of pain experienced by individual horses and how that interferes with their performance and welfare. This paper emphasises the importance of a systematic clinical examination to identify the presence of pain that can be supported by recognition of pathology using a range of diagnostic aids. These will also be reviewed to assist the clinician in understanding the tools available to evaluate a horse with a sore back.