934 BURSITIS OF THE GLUTEUS MEDIUS. 



Bruises are produced by falls, by collisions with the carriage-pole, by 

 blows with heavy bodies, strains resulting from heavy draught-work 

 and by Ealling with the hind limb bent under the body, or when the 

 animal catches the heel of one of the hind shoes in the collar shank. 

 Sudden reining-up is also said to produce it. Horses with sloping 

 quarters and slight muscular development seem predisposed to such 

 injuries. 



Course. The disease consists in a bursitis or tenositis, acute or 

 chronic, the tendency always being towards a chronic condition; 

 but the issue depends to some extent on the initial injury, and on 

 the treatment adopted. Under appropriate treatment, lameness 

 may disappear in four to six weeks ; but if neglected, and especially 

 if the primary injury be severe, the condition may become chronic. 



The prognosis depends chiefly on the stage attained and the 

 severity of the disease. When lameness is recent and slight, and the 

 animal can be rested, there is good hope of recovery, but this is less 

 in heavy draught-horses and in riding-horses than in such as are 

 occupied in the lighter forms of draught. Marked wasting of muscle, 

 the existence of swelling, and severe or chronic lameness render 

 prognosis doubtful ; and where there is periostitis and exostosis, 

 with abrasion of the cartilaginous covering of the bone, there can 

 be little chance of recovery. The suggestion that the bursa some- 

 times communicates with the hip-joint, and that disease may extend 

 to the latter, seems based on insufficient knowledge of anatomy. 



Symptoms. In recent acute inflammation there is increased 

 warmth, swelling and pain on pressure over the great trochanter. 

 When resting, the limb is usually flexed, though sometimes no change 

 can be detected until the horse is exercised. When moving, the for- 

 ward stride is shortened ; less frequently, there is a tendency to lift 

 the limb before the last phase of the stride is complete. The animal 

 generally moves obliquely, as does the dog, the sound side being 

 thrust forward, and the lame limb dragged and rotated more or less 

 inwardly. By placing the hand on the middle trochanter during 

 movement distinct erepitation may sometimes be detected (tendo- 

 vaginitis crepitans) ; at a later stage the muscles of the quarter 

 become atrophied. 



The slighter, and especially the chronic, forms of lameness are 

 often only apparent when turning or when moving heavy loads, 

 the horse then drawing with the sound leg, and endeavouring to 

 shorten the period of loading of the diseased one. 



Similar symptoms, however, are seen in other diseases, such 

 as old cases of fractured pelvis ; the diagnosis must therefore be 



