Veterinary advice should be sought before applying any treatment or vaccine.


Buttress Foot, Pyramidal Disease, Phalangeal Exostoses

Ringbone is a form of osteoarthritis in horses which affects the coffin joint (low ringbone) or the pastern joint (high ringbone). Ringbone can be caused by damage within the joint (articular), or from damage to the structures which surround and support the joint (periarticular), such as the joint capsule or ligaments. When ringbone involves a joint, is it more likely to cause lameness than when it doesn't involve a joint (non-articular).

Ringbone Risk Factors

Horses with poor conformation and/or hoof alignment issues are predisposed to developing ringbone later in life. These include upright pasterns, long toe-low heels, toed-in or toed-out, or improper hoof angle. These flaws exert stress on the horse's joints. Horses participating in certain equestrian disciplines are also more at risk of developing ringbone. Horses used for jumping (landing after the jump), barrel racing (associated with the sharp turns), roping (sudden hard stops), carriage, parade, or police horses (working on pavement).

Clinical Signs of Ringbone

Ringbone symptoms may be difficult to catch in the early stages of the disease. While riding, horses may develop a short, shuffling, or choppy gait, stop performing activities they used to normally do (such as jumping, performing sharp turns, or sudden stops), or appear less willing to move forward. Symptoms may vary from day to day and will differ depending on whether one or both legs are affected. After a short rest period, lameness may appear to have resolved only to return once work is restarted. When low ringbone is severe, it can sometimes cause an obvious bony swelling at the horse's coronet which is sometimes referred to as 'pyramidial disease' or 'buttress foot'.


Abnormal bony enlargement on top of pastern
Mild to moderate lameness
Short, choppy, shuffling gait
Reluctant to move forward
Jump refusal


  • History
  • Clinical signs
  • Physical exam
  • Lameness exam
  • Radiography - Diagnosis of ringbone is through radiography and is important for verifying whether the associated bony changes involve a joint or not, as treatment and prognosis are dependent on this findings.



Slowing the progression of the disease by reducing or controlling the contributing factors to its developmentAchieved through correction of unbalanced foot conformation through corrective shoeing methods, performed by an experienced farrier. Farriers will need to balance the horse's feet and provide complete support to the heel.
Anti-inflammatoriesbute, firocoxib (Previcox or Equioxx)
Legendhyaluronic acid injected intravenously
Adequanpolysulfated glycosaminoglycan injected via IM
Oral joint supplementschondroitin sulfate, glucosamine, hyaluronic acid, MSM
Chiropractic manipulation
Surgery.May be an option for the treatment of high ringbone in certain horses. Between 65-85% of horses treated return to full athletic function.



The prognosis depends on the location of the ringbone and whether a joint is involved.

Scientific Research

General Overviews

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Risk Factors

  • Horses with poor conformation - Long sloping pasterns, very upright pasterns, long toe heel foot shape, unbalanced feet, base narrow, base wide, toed in ('pigeon toed') or toed out ('splay footed') stance
  • Draft horses breeds- that regularly pull heavy loads
  • Athletic horses that regularly perform sudden stops and/or tight turns.