The pictures above are those of a horse with an asymmetric pelvis. Specifically, the left tuber sacrale is lower than the right. Less severe varieties of this problem have been described as "hunters bumps". The appearance of asymmetric tuber sacrale or "hunters bump" is in indication of a pathological problem within the pelvis/sacrum area. In the case above, the gelding suffered a fractured pelvis that was diagnosed via ultrasound. This patient presented for non-weight bearing lameness however many with only mild changes do not present for lameness but rather "poor" performance.
In the image above, the left gluteal region was examined via ultrasound and an irregular margin was noted along the body of the ileum. Note the "step" along the bony margin in the pic below.
Less severe cases involve inflammation within the sacro-iliac joint and/or inflammation of the dorsal sacroiliac ligaments. These areas should be assessed for evidence of inflammation and treatment may include shockwave treatment, mesotherapy, and/or sacro-iliac joint injections.
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