The pastern joint rests between the proximal and distal phalangeal bones. Horses with pastern joint pain present with a wide range of symptoms: from acute lameness to poor athletic performance. The forelimbs are more commonly affected. Physical examination findings include pastern joint distension, heat, and pain on joint manipulation. The most common causes of lameness in the pastern joint are synovitis (inflammation of the joint capsule), luxations, and fractures (especially in athletic horses).