I have had an 11 yr old ottb on trial that I have fallen in love with. He has been previously doing walk/trot/canter work with occasional low jumping. Since I brought him home (2 wks) we have been consistently jumping. He is perfectly sound Undersaddle and shows no sign of lameness, pain, or discomfort. I had the vet come do a PPE and she immediately noted that his front left fetlock was larger than the right. When she did the flexion test, she gave him a 3-4/5. His fetlock is also not sore to the touch. Considering having X-rays done… what do you think the issue could be? Is it worth having X-rays? His job would be hunters up to 2’6".
Do the radiographs so you will know what is going on. Many OTTBs have jewelry.
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In addition to X-rays, I would also get an ultrasound. This enlarged joint could be from bone damage and/or soft tissue damage. Best to pay a bit more upfront to know exactly what you’re getting into!
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Xrays at minimum. 3-4/5 indicates something is going on. If you had said 1/5 my vet would say that is pretty normal for 11 no matter what. But 3-4? Definitely xrays to start, and go from there.
I say this as the owner of a permanently lame DWB - 13 years old. PPE was pretty good; flexions were 1 and 1.5. Had we done xrays we probably would have found this old injury which ultimately caused her to be unsound enough to retire. 
But she was inexpensive and it seemed silly to pay as much for the PPE as the horse. In retrospect…however…I should have.
It’s hard to know how much/how little to do - but horses live a long time. What will you do if this horse is unsound in a year like mine?
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I agree with Lusoluv. I don’t know what you are planning to pay for him, but do the work upfront so you aren’t out of luck in the long run. I hate the flexion test, but if he is a 4/5 I would look into it.
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Knowledge is power.
I bought Yo with the simplest, cheapest PPE when he was 6, and had him for nearly 24 years with only minor hiccups that could have been predicted.
That being said… knowledge is power.
Flexions can be misleading by themselves but when combined with a knowledgeable vet who notes a size difference in one fetlock? That means you go on to x ray IF the horse seems otherwise sound. If the horse wasn’t going sound to start with and flexes a 3-4/5, you walk away and keep looking.
This one has been sound in work so, yes, x Ray. You need to know what’s up so you can manage him properly so he doesn’t get unsound.
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What was his job in the months/years before you took him on trial? I would worry less about even a 3 flexion if he’s been in solid work, of the type you want, for long enough before you took him, than I would if he’s been a pasture ornament or light trail horse for the last year,
An enlarged ankle may be osselets, which are common in OTTBs, and while they could easily be sore after flexing (especially if done too hard), usually don’t cause any issues with extension. And really all the work done is in the extended state, ie weight-bearing.
Xrays are the only thing that’s going to show you what’s in there. You definitely want to know if there’s a chip of some sort that is “activated” with a flex test.
Thank you everyone. In the years before I had him he had been doing consistent walk/trot/canter with occasional jumping. I know a girl owned him once who consistently jumped him 2 ft. I’ve been doing 2ft throughout the trial and he has shown no signs of lameness or discomfort. Do you think it could be arthritis? Either way do you think this is manageable and with what kind of maintenance? His job would be hunters only up to 2’6". I
You really need a radiograph to have any idea what the answer may be to those questions. 
I would be AWFULLY suspicious of a chip, having gone down that road with a couple OTTBs. Chips are often not a problem, until they are, and then it can be career ending. Surgery could be curative, or not, depending on how much of the cartilage is gone.
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Can’t say without x rays. 2’ is really not jumping, it’s a canter stride over, they don’t rock back and push off behind and don’t land all their weight in front, most horses can easily do them even with some physical limitations, and they can do a lot of them. 2’6" starts to require more of an actual jump (though not much) and is where physical limitations start to show up, 3’ most horses start getting a bit of airtime over the jump and you really see unsoundnesses.
If you have any intention of moving up to 2’6 on a regular basis for lessons and showing, maybe try a little 2’9"-3’? I would definately want x rays…unless you want to keep him for something else. Best find out what’s wrong before making a commitment to him.
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When I’ve been jumping him even over 2ft he has been taking them HUGE. Probably about 3ft. He isn’t super experienced. But even with taking them so huge he has shown no sign of lameness or pain… would that show if it was something serious? Having X-rays done today got an appt
No, he would not necessarily take off steps over some large efforts, even if something serious is going on in the fetlock.
Glad you’re getting the radiographs! Hope nothing concerning pops up.
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No, wouldn’t necessarily see it. Generally it doesn’t really show until you start doing courses including spreads/oxers where you repeat the jumping over 15-20 fences from a consistent canter without stopping 2-4 times a week. Which is what you do when you get serious and take 2 lessons a week plus showing.
You don’t want to get to that point and discover he can’t do it and stay sound. Here you are saying he’s relatively inexperienced about jumping? Definately need the x rays, whatever he’s been doing is not what it sounds like you will be asking him to do.
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Ok any opinions on what it could be? I’ve heard osselts, arthritis, bone chip, soft tissue injury… anything else? And which (if any) of those could be manageable to keep a horse sound to jump?
Not without x rays/ultrasound/ and blocking. All we can give is educated guesses based on the info you have provided. But chances are if the horse is off with just starting jumping and having issues, he probably will not hold up long term.
@luvmyhackney but he hasn’t been off. He’s been completely sound Undersaddle including jumping. That’s why I don’t understand this
Hannah, until you get the results from the radiographs, no one here can tell you what’s wrong with the horse or what the prognosis is. Really. You’re asking a “how long is a piece of string” question.
Come back once you have the radiographs and I’m sure we’ll offer you 100 different scenarios and opinions on how he’ll do
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Ok thank you 
will update this evening
Agree that you need to do x-rays and ultrasound and go from there, based on what you find.
I took my 4-year-old horse for a routine lameness eval as part of his wellness package with my vet. I was suspecting no problems and he was progressing nicely on the barrel pattern. She flexed his right front and he trotted off dead lame. Did x-rays (clean) and ultrasound and found a very small pocket of fluid in the tendon. We caught it very early, which makes me glad I opted to do “routine” lameness exams for them.
Waiting to see what you found out from the vet.
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