Have you heard of Suture Line Periostitis? – Does your horse have a bump between its eyes? READ ON!

Wednesday, February 20th, 2019 | Filed under Medical

I follow the vet Grace Owen, DVM, on Facebook.

Often, she will show images and give explanations on interesting and rare cases.  Recently, she wrote about Suture Line Periostitis.

Here is Dr. Owen’s article:

Interesting case: This mare had a run in with a fence. Swelling went down over time but left this odd “bump”. This is known as Suture Line Periostitis, or inflammation of the suture lines. Diagnosis involves ruling out other conditions that may cause swelling of the head. Often these are not painful. If the area is painful NSAIDS (Non-Steroidal Anti-Inflammatories) may be beneficial, but there is no proven therapy. Often just monitoring the area is recommended. Sometimes the area will not go completely back to normal, but as they are not painful they often just add character.

This is her patient.  Note the big bump.

Equine skull where you can see the suture lines.

side view

Radiograph showing the inflammation at the suture line (I’m taking her word for it since I cannot read Xrays.)


Click here to go to the original article.

Although it may be surprising, the equine (and any vertebrate) skull is actually made up of separate bones that are joined by a slightly flexible junction called a bone suture. These junctions allow very slight movement of the bones as the head grows, allowing growth of the brain and other internal structures. A human baby’s fontanelle is a large suture and allows rapid change in skull size in the very young growing human.

In horses, abnormal development of skull sutures can result in hard swellings on the head. This condition is not fully understood but likely related to traumatic injury.

Suture periostitis is more common in young horses but can develop in mature horses. In the cases I have seen, the presumed reason for the appearance of these swellings has been a traumatic episode. In younger horses they may result from trauma, congenital or nutritional causes.

If they occur at the suture near the eye, the swelling can cause blockage of the naso-lacrimal duct (the tube that normally carries tears through the bone to the nostril) and result in tearing. It can also cause swelling of the tissues around the eye.

These bumps usually are not painful. The most common appearance is a horizontal ridge of hard swelling on the forehead between the eyes or down the side of the face in front of the eye.

DIAGNOSIS involves ruling out other conditions that result in head swelling. This involves careful physical examination, dental exam, and head radiographs. The appearance of suture periostitis is typically different than Nutritional Secondary Hyperparathyroidism (“Big Head” or “Bran” Disease) but there is some overlap in appearance, so that condition needs to be carefully considered and ruled out.

There is no TREATMENT for this condition. Over time, these bumps usually smooth out and become less obvious.


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2 comments have been posted...

  1. Unicorn Tales

    Real-life UNICORN! Yes — One of my rescued horses was playing some years ago and bonked his forehead — terribly — above and between his eyes. Bloody nose for a few days, we had the vet monitor the trauma to make sure no side effects, had him on NSAIDS, etc. Eventually? That “SUTURE LINE PERIOSTITIS” formed and honestly looked like we had an honest-to-goodness UNICORN on our property (he is a blue roan that roaned out, is almost white now…). It was both amazing and sad… What we didn’t know is that it would slowly decrease in time. After 4 years, just a small hump remains on his forehead, but he will always be my special Unicorn….

  2. Calvin48

    I very much enjoy reading the blogs of David Ramey, DVM. He’s down-to-earth and funny.

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