Retrospective analysis of horses with ultrasound evaluation of the sacroiliac region and response to local corticosteroid injection: 42 cases.
Authors: Ellis Katherine L, Seabaugh Kathryn, King Melissa R
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Sacroiliac Injection Outcomes in Equine Practice Sacroiliac region pain represents a common diagnosis in performance horses, yet uncertainty remains about which diagnostic findings and treatment approaches predict successful return to work following local corticosteroid injection. This retrospective analysis of 42 horses examined whether ultrasound findings, injection technique, or corticosteroid choice could predict functional outcomes, with success defined as return to the same or higher level of performance. Just over 60% of horses achieved their target performance level, whilst 10% returned to reduced work and 28% failed to return to any level of function; notably, horses receiving methylprednisolone were 4.2 times more likely to return to performance than those injected with triamcinolone, regardless of ultrasound findings. Ultrasonographic changes in the SI region—whether structural abnormalities, ligamentous involvement, or other pathological features—did not correlate with prognosis, suggesting that ultrasound assessment may be more valuable for technique guidance and ruling out other pathology than for outcome prediction. For practitioners, this indicates that corticosteroid selection warrants careful consideration for SI injections, whilst acknowledging that ultrasound-identified lesions should not unduly pessimistic prognostication, and that approximately 40% of horses may require alternative or complementary interventions to achieve functional recovery.
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Practical Takeaways
- •When performing sacroiliac injections with corticosteroids, consider methylprednisolone over triamcinolone as it showed significantly better return-to-performance outcomes
- •Ultrasound findings alone should not be used to predict whether a horse with sacroiliac pain will respond to corticosteroid injection and return to work
- •Expect variable outcomes: roughly 2 in 3 horses return to performance, while 1 in 4 may not return to work despite injection
Key Findings
- •62% of horses (26/42) returned to the same or higher level of work after sacroiliac injection with corticosteroids
- •Horses injected with methylprednisolone were 4.2 times more likely to return to performance than those injected with triamcinolone
- •Ultrasound findings of the sacroiliac region did not predict return to performance following injection
- •28% of horses (12/42) did not return to work at any level after sacroiliac injection