Unusual osteochondral lesions of the talus in a horse

A 2-year-old Thoroughbred gelding was evaluated for a grade 3 out of 5 unilateral hind limb lameness. Flexion of the right hock and stifle joints (spavin test) exacerbated the lameness. Response to intra-articular and perineural anaesthesia isolated the source of lameness to the tarsocrural area, despite an absence of tarsocrural joint effusion. Routine radiographic examination of the hock did not reveal any significant abnormalities. Skeletal nuclear scintigraphic evaluation revealed a focal region of increased bone activity in the proximal medial trochlear ridge of the talus. Flexed lateromedial radiographic views identified three discrete semicircular lytic lesions at the proximal articular margin of the medial trochlear ridge of the talus. Conservative management of the lesions was associated with a successful return to racing. The location and appearance of the osteochondral lesions of this report have not been previously reported and may be a manifestation of developmental orthopaedic disease and abnormal endochondral ossification. Nuclear scintigraphy and flexed lateromedial radiographic views facilitated identification of the lesions. This radiographic view is recommended when lameness is isolated to the tarsocrural joint and standard radio-graphic projections fail to identify a cause.