The navicular bone is a small, boat-shaped bone located in the hoof of a horse, specifically situated behind the coffin bone and beneath the deep digital flexor tendon. It plays a role in the biomechanics of the equine foot by acting as a fulcrum for the deep digital flexor tendon, aiding in the horse's movement and weight distribution. The navicular bone is part of the navicular apparatus, which includes surrounding ligaments and the bursa, a fluid-filled sac that reduces friction. Issues with the navicular bone and associated structures can lead to a condition known as navicular syndrome, which is characterized by lameness and pain in the front feet. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, and pathophysiology of the navicular bone, as well as diagnostic and treatment options for navicular-related conditions in horses.
Quam VG, Belacic ZA, Long S, Rice HC, Dhar MS, Durgam S.Safe, efficacious therapy for treating degenerate deep digital flexor tendon (DDFT) and navicular bone fibrocartilage (NBF) in navicular horses is critically necessary. While archetypal orthobiologic therapies for navicular disease are used empirically, their safety and efficacy are unknown. Mesenchymal stem cell-derived extracellular vesicles (EV) may overcome several limitations of current orthobiologic therapies. Objective: To (1) characterise cytokine and growth factor profiles of equine bone marrow mesenchymal stem cell (BM-MSC)-derived extracellular vesicles (BM-EV) and (2) evaluate the ...
Steiner J, Richter H, Kaufmann R, Ohlerth S.Single-source dual energy (SSDECT) and detector-based spectral computed tomography (DBSCT) are emerging technologies allowing the interrogation of materials that have different attenuation properties at different energies. Both technologies enable the calculation of effective atomic number (EAN), an index to determine tissue composition, and electron density (ED), which is assumed to be associated with cellularity in tissues. In the present prospective observational study, EAN and ED values were determined for 16 zones in normal subchondral and trabecular bone of 37 equine cadaver limbs. Using...
Fuss FK.The horse's navicular bone is located inside the hoof between the deep flexor tendon (DDFT) and the middle and end phalanges. The aim of this study was to calculate the stress distribution across the articular surface of the navicular bone and to investigate how morphological variations of the navicular bone affect the joint forces and stress distribution. Joint forces normalised to the DDFT force were calculated from force and moment equilibria from morphological parameters determined on mediolateral radiographs. The stress distribution on the articular surface was determined from the moment ...
Esselman AM, Johnson SA, Frisbie DD, Barrett MF, Zhou T, Contino EK.Radiographs are a common diagnostic tool utilised during pre-purchase examinations, yet differences surround their interpretation among equine veterinarians. Objective: (1) To determine veterinarians' subjective impressions of a spectrum of radiographic abnormalities regarding suitability for purchase; (2) To determine how veterinarians' years in practice, primary discipline or board certification status influence their subjective impression of radiographic abnormalities, and (3) To determine how horses' discipline, current level of work (working at intended level vs. future prospect) and buye...
Larsen EA, Williams MR, Schoonover MJ, Jurek KA, Young JM, Duddy HR.Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of ...
Barrett MF, Goorchenko GE, Frisbie DD.Damage to the soft tissue structures of the digit is a common source of equine lameness. While magnetic resonance imaging (MRI) allows for the most complete diagnostic imaging of the equine digit, ultrasound is more readily available and less expensive. This prospective diagnostic accuracy study compares ultrasound to MRI for the diagnosis of injuries visible with ultrasound within the digit, including the deep digital flexor tendon (DDFT), collateral sesamoidean ligament (CSL), and navicular bursa. Clinical patients underwent an MRI of the digit and a blinded ultrasound of the digit between t...
Belacic ZA, Sullivan SN, Rice HC, Durgam SS.To investigate the effects of interleukin-1β (IL-1β) and methylprednisolone acetate (MPA) on equine intrabursal deep digital flexor tendon (DDFT) and navicular bone fibrocartilage (NBF) cells in vitro. Methods: Third passage DDFT and NBF cells from 5 healthy donor horses ages 11-17 years euthanized for reasons unrelated to musculoskeletal conditions. Methods: Aggregate cultures were incubated with culture medium alone (control), 10 ng/mL IL-1β, 10 ng/mL IL-1β + 0.05 mg/mL MPA, or 10 ng/mL IL-1β + 0.5 mg/mL MPA for 24 hours. Extracellular matrix (ECM) gene expressions were assessed via rea...
Brock BA, Greer HR, Honnas CM, Gilleland BE, Barrett MF, Moore JN, Cohen ND.Podotrochlear syndrome is a common cause of lameness in Quarter Horses involving both soft tissue and bony structures within the heel region. Current surgical treatment of podotrochlear syndrome addresses pathological changes affecting the soft tissue structures of the navicular region but does not address either edema or cyst-like lesions of the navicular bone. Unassigned: The objective of this randomized, self-controlled case series was to determine whether core osteostixis improved lameness in Quarter Horses with podotrochlear syndrome characterized by bilateral magnetic resonance imaging (...
Zaha C, Schuszler L, Dascalu R, Nistor P, Florea T, Imre K, Rujescu C, Sicoe B, Igna C.Horses with palmar foot pain do not show a typical increase in temperature in the palmar aspect of the hoof and heel due to low blood flow. The objectives of the current study were to determine the changes and differences in the thermographic pattern of the sole surface in horses with unilateral palmar foot pain and non-lame horses before and after training. We hypothesized that the thermal pattern and the local temperature of the frog area and toe area would be similar, with an increased local temperature after training in both lame and non-lame horses. A pilot study was conducted to investig...
McParland TJ, Horne CR, Robertson JB, Schnabel LV, Nelson NC.Limited information exists regarding associations between distal interphalangeal joint (DIPJ) abnormalities and synovial invagination changes in the distal sesamoid (navicular) bone. This retrospective, analytical study aimed to measure specific characteristics of the synovial invaginations of the navicular bone to determine whether any single characteristic was associated with abnormalities in the DIPJ or navicular apparatus (NA) using high field MRI and a sample of 200 horses' feet. The DIPJ and NA were graded independently by three scorers. The grades were averaged, creating a global pathol...
Sannajust K, Spriet M, Anishchenko S, Beylin D.Maximal standardized uptake values (SUV ) are commonly used for the interpretation of PET studies. Limited information regarding the SUV of F-NaF PET in horses is currently available in the literature. The goals of this retrospective secondary analysis study were to provide reference values for F-NaF SUV in the equine distal extremity and assess the effect of attenuation correction. Nonattenuation corrected (NAC) and CT-based attenuation corrected (CTAC) SUV were obtained from 19 feet and 19 fetlocks. Twenty regions of interest (ROIs) were defined for the foot and 22 for the fetlock. Areas p...
Brounts SH, Lund JR, Whitton RC, Ergun DL, Muir P.To evaluate the diagnostic capabilities of a novel helical fan beam CT system used for imaging of horses with a range of clinical distal limb problems. 167 horses. Medical records were reviewed of horses presented for CT of the distal limb at 2 university-based veterinary hospitals. The following data were recorded: age, sex, breed, presenting complaint, sedation used for imaging, scanning time, procedure time, other diagnostic imaging methods performed, imaging diagnosis, clinical diagnosis, and complications during imaging. Most horses were Thoroughbreds and Quarter Horses. Procedure times r...
Cota LO, Malacarne BD, Dias LA, Neto ACP, Kneipp MLA, Cavalcante MA, Cunha MSLD, Paz CFR, Carvalho AM, Faleiros RR, Xavier ABDS.The analgesic specificity of navicular bursa (NB) anesthetic infiltration is still questionable. The study aimed to determine the mechanical nociceptive threshold of non-specific analgesia in the dorsal lamellar stratum, as well as in the sole, coronary band, and heel bulbs of the hoof, after navicular bursa anesthetic infiltration. Six healthy horses with no clinical or radiographic changes of the digits and no communication between the NB and the distal interphalangeal joint, were used. After random selection, the NB of one of the forelimbs was infiltrated with 2% lidocaine and the contralat...
Katrinaki V, Estrada RJ, Mählmann K, Kolokythas P, Lischer CJ.The outcome and interpretation of intra-synovial diagnostic analgesia of the distal interphalangeal joint (DIPJ) and the navicular bursa (NB) remain in dispute, and no objective studies have been carried out to establish the percentage of improvement over time from these two analgesia techniques. Objective: To investigate the qualitative and time-dependent outcome of DIPJ-A and NB-A in naturally occurring forelimb lameness. Methods: Case series. Methods: Twenty-three clinical cases with forelimb lameness were evaluated objectively using a body mounted inertial sensor system (BMIS). Lameness wa...
Elane GL, Biedrzycki AH, McCarrel TM, Banks SA, Morton AJ.To quantify the translation and angular rotation of the distal sesamoid bone (DSB) using computed tomography (CT) and medical modeling software. Methods: 30 thoracic limbs from equine cadavers. Methods: Partial (n = 12), full (8), and matched full and subsequently transected (10) thoracic limbs were collected. Bone volume CT images were acquired in three positions: extension (200° metacarpophalangeal angle), neutral (180°), and maximal flexion (110°). Mean translation and angular rotation of each DSB were recorded. Differences were determined with two-way ANOVA and post hoc Tukey's tests fo...
Sanigavatee K, Poochipakorn C, Charoenchanikran P, Joongpan W, Chanda M.Z-bar shoeing has been implemented to relieve uniaxial palmar pain arising from the structures in the affected region. However, there have been no reports on the long-term application of the z-bar shoe during exercise training regimens. A 10-year-old mixed-breed show jumping pony presented with an occasional short stride and abnormal rhythm while turning during routine exercise for three months. Gait analysis conducted by trotting off on both hard and soft surfaces showed no lameness in the straight line on both types of surfaces. However, right forelimb lameness was detected with moderate and...
Peeters MWJ, Thursby JJ, Watson HE, Berner D.Palmaroproximal-palmarodistal oblique (PaPr-PaDiO) radiographs are regularly obtained for a full evaluation of the navicular bone (NB). Despite their routine use, different acquisition techniques are described. Objective: To determine optimal foot placement and beam angle for obtaining PaPr-PaDiO views. Methods: In vitro experiment. Methods: A convenience sample of 26 disarticulated forelimbs were placed in six different positions using a leg press to mimic the weight-bearing position. In each position, navicular PaPr-PaDiO images were obtained with eight different beam angles. The resulting 1...
Pauwels F, Hartmann A, Alawneh J, Wightman P, Saunders J.The poor soft tissue conspicuity of CT can be improved by using intra-arterial CT Angiography (CTA), and intra-articular and intra-bursal contrast enhanced CT (CTAR). This retrospective study describes a combination protocol of CT and CTA of the horse's foot, and CTAR of the distal interphalangeal joint and navicular bursa. It is hypothesized this would provide a comprehensive overview of the range and severity of distal limb pathology. Radiology reports of all horses admitted for distal limb CT over a 5 year period were reviewed. All horses with a complete four stage CT examination and radiol...
Evrard L, Joostens Z, Vandersmissen M, Audigié F, Busoni V.This prospective study aimed to blindly compare the ultrasonographic and standing magnetic resonance imaging (sMRI) findings in deep digital flexor tendon (DDFT), navicular bone, and navicular bursa in horses with foot pain, positive digital analgesia, and without definitive radiographic diagnosis. Ultrasonography detected more DDFT abnormalities (32/34 feet vs. 27/34 with sMRI) but identified less palmar navicular abnormalities (23/34 feet vs. 30/34 with sMRI). In suprasesamoidean DDFT lesions, which were mainly dorsally located, changes in echogenicity did not correspond to a particular patt...
Osborn ML, Cornille JL, Blas-Machado U, Uhl EW.Navicular syndrome has been traditionally characterized by progressive lameness with chronic degeneration of the navicular bone. Advances in imaging techniques have revealed that its associated soft tissue structures are also affected. This distribution of lesions is explained by conceptualizing the equine navicular apparatus as an enthesis organ that facilitates the dissemination of mechanical stress throughout the tissues of the foot. The navicular apparatus has the same structural adaptations to mechanical stress as the human Achilles tendon complex. These adaptations efficiently dissipate ...
Perez-Jimenez EE, Biedrzycki AH, Morton AJ, McCarrel TM.To determine the influence of a custom 3D-printed guide for placement of cortical bone screws in the equine navicular bone. Methods: Ex vivo study. Methods: Eight pairs of normal adult equine forelimbs. Methods: A 3.5 × 55 mm cortical screw was placed in the longitudinal axis of each intact navicular bone. Screws were placed with a 3D-printed guide (3D) in one bone and with a traditional aiming device (AD) in the contralateral bone within each pair. Duration of surgery and the number of fluoroscopy images were compared between techniques. Screw placement was subjectively evaluated by gros...
Sullivan SN, Cole SL, Stewart MC, Brokken MT, Durgam S.To investigate the effects of triamcinolone acetonide (TA) and methylprednisolone acetate (MPA) on the viability of resident cells within the fibrocartilage on the dorsal surface of the deep digital flexor tendon (FC-DDFT) and fibrocartilage on the flexor surface of the navicular bone (FC-NB) of horses. Methods: 12 to 14 explants of FC-DDFT and of FC-NB from grossly normal forelimbs of 5 cadavers of horses aged 9 to 15 years without evidence of musculoskeletal disease. Methods: Explants were incubated with culture medium (control) or TA-supplemented (0.6 or 6 mg/mL) or MPA-supplemented (0.5 or...
Biedrzycki AH, Kistler HC, Perez-Jimenez EE, Morton AJ. The aim of this study was to evaluate the surgical execution of a virtual surgical plan (VSP) with three-dimensional (3D) guides against a freehand approach in the equine navicular bone using an automated computer analysis technique. Methods: Eight pairs of cadaveric forelimb specimens of adult horses were used in an experimental study design with modelling. Limbs received either a 3.5 mm cortical screw according to a VSP or using an aiming device. Using computed tomography and computer segmentation, a comparison was made between the executed screw and the planned screw using the Ha...
Schenzel S, Rohde C, Fugazzola MC.A three-week-old warmblood colt was referred for a two-week history of lameness on the left thoracic limb, and a two-month-old Quarter Horse-mix filly was referred for malaligned pelvic limbs since birth. The foals were diagnosed with agenesis and dysgenesis of the navicular bone, respectively. In this report, we present clinical signs, diagnostics, and postmortem workup of the two cases.
Norvall A, Spriet M, Espinosa P, Ariño-Estrada G, Murphy BG, Katzman SA, Galuppo LD.Increased 18 F-Sodium Fluoride (18 F-NaF) uptake at the chondrosesamoidean ligament (ChSL) attachment on the distal phalanx was identified in an exploratory positron emission tomography (PET) study. The prevalence and significance of this lesion has not been previously investigated. Objective: The goal of this study was to assess the prevalence of this lesion, its association with other imaging findings and with clinical signs. Methods: Retrospective cross-sectional analytical study. Methods: All horses with 18 F-NaF PET and computed tomography (CT) imaging of the feet performed between Octobe...
Hontoir F, Paques F, Simon V, Balau B, Nicaise C, Clegg P, Dugdale A, Vandeweerd JM.Foot pain is a frequent cause of lameness in horses and can involve multiple structures within the hoof. The T-ligament (an anatomical structure connecting the synovium of the distal interphalangeal joint, the digital flexor tendon sheath and the navicular bursa) is poorly described. Five pairs of equine cadaver distal forelimbs were collected from a slaughterhouse. Sagittal sections (medial, middle and lateral) were obtained and processed with Haematoxylin Eosin Safran, Unna's Orcein, and Picrosirius red stains. Histological assessment revealed that the T-ligament was covered by the surroundi...
Gutierrez-Nibeyro SD, Werpy NM, Gold SJ, Olguin S, Schaeffer DJ.Foot pain is a common presenting complaint in Warmblood horses. The aim of this retrospective, cross-sectional study was to determine the spectrum of foot lesions detected by magnetic resonance imaging (MRI) in Warmblood horses used for dressage, jumping, and eventing. The medical records of 550 Warmblood horses with foot pain that were scanned using standing MRI were reviewed and the following data were recorded: signalment, occupation, lameness, diagnostic analgesia, imaging results, treatments, and follow-up assessments. Associations between standing MRI lesions and chronic lameness followi...
Kottmeier LK, Seehusen F, Helweg M, Rohn K, Stadler P, Hellige M.Magnetic resonance imaging and the correlation to histopathological findings of the equine palmar foot of lame horses have been described previously, using 0.27 and 1.5 T systems. Compared to these, 3 T systems provide superior spatial resolution and imaging contrast. The aim of our prospective anatomic study was to characterize the imaging anatomy of the navicular region on 3 T MRI in comparison to histopathological findings. We hypothesized that 3 T MRI allows a good visualization of the entire navicular apparatus and reliable measurements of navicular cartilage and cortical bone thickness. ...
Moyer CT, Bramlage LR, Werre SR, Ruggles A, Embertson R, Hopper S.To describe the presence of fragments in the dorsal proximal interphalangeal (PIP) joint and to report flat racing performance after surgical treatment. Methods: Retrospective study. Methods: Thirty-nine affected thoroughbred flat racehorses and 169 age- and sex-matched maternal siblings. Methods: Medical records from 2000 to 2015 were reviewed for thoroughbred horses that underwent arthroscopic removal of osteochondral fragments in the dorsal aspect of the PIP joint. The horses' 2-year-old year, 3-year-old year, and career athletic performances were compared with their matched siblings. Resul...
Argüelles D, Saitua A, de Medina AS, Muñoz JA, Muñoz A.Navicular syndrome, a common cause of equine forelimb lameness, is associated with pathological changes in the navicular bone. Consequently, administration of bisphosphonates (BPs) has been advocated in order to modify the rate of bone turnover. The present study aimed to assess the clinical efficacy of intramuscularly administered clodronic acid for the treatment of 11 horses with clinical and radiographic findings compatible with navicular syndrome. Magnetic resonance imaging was performed in 5 of the 11 horses. The animals were treated with an intramuscular dose of clodronic acid of 765 m...
Dyson SJ, Murray R, Schramme MC.The diagnosis of foot-related lameness often remains elusive and it can be difficult to offer rational treatment, or to predict outcome. Objective: To describe the spectrum of injuries of the foot identified using magnetic resonance imaging (MRI), to determine their relative prevalence among MRI diagnoses and to establish the long-term results of treatment. Methods: The MR images of horses examined from January 2001--December 2003 were reviewed. Horses were selected for MRI if the pain causing lameness was localised to the foot using perineural analgesia but any clinical, radiological or ultra...
Denoix JM, Thibaud D, Riccio B.Bisphosphonates, such as tiludronate, are used to normalise bone metabolism via inhibition of bone resorption. Areas of increased bone resorption and formation are typical lesions in a diseased navicular bone. Objective: To determine if bone remodelling changes occurring in navicular disease may be corrected with therapies regulating bone metabolism. Methods: We designed a double-blind, placebo-controlled clinical trial to compare 2 doses of tiludronate, 0.5 mg/kg and 1 mg/kg bwt administered via daily i.v. injections over 10 days for the treatment of navicular disease. Seventy-three horses, s...
Wilson AM, McGuigan MP, Fouracre L, MacMahon L.Mechanical overload due to poor conformation or shoeing has been suggested to contribute to the development of navicular disease. While studies have determined the compressive force exerted on the navicular bone in normal horses, this has not been reported for horses with navicular disease. Also, the force has not been converted to stress by correction for contact area. In this study we developed a technique for the determination of the contact area between the deep digital flexor tendon and the navicular bone in vivo, and used a forceplate system to determine the force and stress on the bone ...
Blunden A, Dyson S, Murray R, Schramme M.Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. Objective: Abnormalities of the collateral sesamoidean ligaments (CSLs), distal sesamoidean impar ligament (DSIL), deep digital flexor tendon (DDFT), navicular bone, navicular bursa, distal interphalangeal (DIP) joint or collateral ligaments (CLs) of the DIP joint may contribute to palmar foot pain. Methods: Feet were selected from horses with a history of unilateral or bilateral forelimb lameness of at least 2 months' duration that was improv...
Blunden A, Dyson S, Murray R, Schramme M.Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. Objective: Abnormalities of the deep digital flexor tendon (DDFT) may contribute to palmar foot pain; ageing degenerative changes may be seen in horses free from lameness; and horses with lameness are likely to have a greater severity of abnormalities than age-matched horses with no history of foot pain. Methods: Feet were selected from horses with a history of uni- or bilateral forelimb lameness of at least 2 months' duration. Histology of th...
Dyson S, Murray R.To improve understanding of the interrelationships between injuries of the podotrochlear apparatus and deep digital flexor tendon (DDFT). Objective: There is a difference in frequency of different types of lesions at different anatomical sites of the DDFT. Lesions of the collateral sesamoidean ligament (CSL), distal sesamoidean impar ligament (DSIL), distal interphalangeal (DIP) joint and navicular bursa are seen in association with lesions of the navicular bone. Methods: The magnetic resonance (MR) images of 264 horses with unilateral or bilateral foot pain were analysed and graded. Descripti...
Waguespack R, Hanson RR.Navicular syndrome is a chronic and often progressive disease affecting the navicular bone and bursa, deep digital flexor tendon (DDFT), and associated soft tissue structures composing the navicular apparatus. This syndrome has long been considered one of the most common causes of forelimb lameness in horses. Diagnosis of navicular syndrome is based on history, physical examination, lameness examination, and peripheral and/or intraarticular diagnostic anesthesia. Several imaging techniques (e.g., radiography, ultrasonography, nuclear scintigraphy, thermography, computed tomography [CT], magnet...
Pool RR, Meagher DM, Stover SM.Navicular syndrome is a degenerative disorder of the distal half of the flexor surface of the proximal sesamoid bone that is predisposed by faulty foot conformation. In horses that become symptomatic, the faulty conformation results in sustained application of nonphysiologic pressure by the deep digital flexor tendon against the flexor cortex of the bone. This force stimulates an intense bone remodeling response in order to attenuate the pressure. An unfortunate sequela of this response is active hyperemia and edema formation in the medullary cavity of the bone. The edema is organized by fibro...
Smith MR, Wright IM, Smith RK.Clinical lesions of the deep digital flexor tendon and navicular bone are being reported with increasing frequency. However, the role of direct visualisation by navicular bursoscopy in the diagnosis and management of such injuries has not been explored. Objective: Navicular bursoscopy: 1) corroborates information obtained from other, noninvasive imaging modalities; 2) allows direct visualisation of lesions unidentified by other diagnostic modalities; 3) provides further information on morphology of lesions; and 4) permits minimally invasive surgical access to lesions. Methods: The case records...
Murray RC, Schramme MC, Dyson SJ, Branch MV, Blunden TS.Palmar foot pain is a common cause of lameness. Magnetic resonance imaging (MRI) has the potential to detect damage in all tissues of the equine foot, but an understanding of the differences in magnetic resonance (MR) images between feet from horses with and without palmar foot pain is required. This study aimed to describe MR findings in feet from horses with no history of foot-related lameness, and to compare these with MR findings in horses with lameness improved by palmar digital local analgesia. Thirty-four limbs from horses euthanized with a clinical diagnosis of navicular syndrome (amen...
van Hoogmoed LM, Snyder JR, Thomas HL, Harmon FA.Prepurchase examinations of horses are used increasingly as a means of evaluating future soundness. Data is lacking in the literature of the radiographic findings and results of the lameness examination of comprehensive prepurchase examinations. Objective: To summarise the clinical and radiographic findings of prepurchase examinations and determine if radiographic findings correlated with the lameness examination and sale outcome. Methods: Records of 510 cases were reviewed, radiographs evaluated and grades assigned the navicular bone, distal phalanx, and tarsus. Follow-up information on the h...
Gutierrez-Nibeyro SD, Werpy NM, Gold SJ, Olguin S, Schaeffer DJ.Foot pain is a common presenting complaint in Warmblood horses. The aim of this retrospective, cross-sectional study was to determine the spectrum of foot lesions detected by magnetic resonance imaging (MRI) in Warmblood horses used for dressage, jumping, and eventing. The medical records of 550 Warmblood horses with foot pain that were scanned using standing MRI were reviewed and the following data were recorded: signalment, occupation, lameness, diagnostic analgesia, imaging results, treatments, and follow-up assessments. Associations between standing MRI lesions and chronic lameness followi...
Erkert RS, MacAllister CG, Payton ME, Clarke CR.To use force plate analysis to evaluate the analgesic efficacies of flunixin meglumine and phenylbutazone administered i.v. at typical clinical doses in horses with navicular syndrome. Methods: 12 horses with navicular syndrome that were otherwise clinically normal. Methods: Horses received flunixin (1.1 mg/kg), phenylbutazone (4.4 mg/kg), or physiologic saline (0.9% NaCI; 1 mL/45 kg) solution administered IV once daily for 4 days with a 14-day washout period between treatments (3 treatments/horse). Before beginning treatment (baseline) and 6, 12, 24, and 30 hours after the fourth dose of each...
Holroyd K, Dixon JJ, Mair T, Bolas N, Bolt DM, David F, Weller R.Foot conformation in the horse is commonly thought to be associated with lameness but scientific evidence is scarce although it has been shown in biomechanical studies that foot conformation does influence the forces acting on the deep digital flexor tendon (DDFT) and the navicular bone (NB). The aim of this study was to determine the relationships between foot conformation and different types of lesion within the foot in lame horses. It was hypothesised that certain conformation parameters differ significantly between different types of foot lesions. Conformation parameters were measured on m...
Williams GE, Silverman BW, Wilson AM, Goodship AE.To assess the force plate as a diagnostic aid in equine locomotor abnormalities, particularly for abnormalities such as navicular disease that do not have specific diagnostic criteria. Methods: 17 Thoroughbreds without observable locomotor abnormalities (group A), 6 Thoroughbreds with superficial digital flexor tendon injury (group B), and 8 Thoroughbreds with navicular disease (group C). Methods: Using a force plate, ground reaction force patterns were recorded at the trot. Peak limb vertical force and force/time curve parameters were derived from 4 identifiable points at the beginning and en...
Murray RC, Blunden TS, Schramme MC, Dyson SJ.Magnetic resonance (MR) imaging is increasingly used in the diagnosis of equine foot pain, but improved understanding of how MR images represent tissue-level changes in the equine foot is required. We hypothesized that alterations in signal intensity and tissue contour would represent changes in tissue structure detected using histologic evaluation. The study objectives were to determine the significance of MR signal alterations in feet from horses with and without lameness, by comparison with histopathologic changes. Fifty-one cadaver feet from horses with a history of lameness improved by pa...
Busoni V, Heimann M, Trenteseaux J, Snaps F, Dondelinger RF.We describe the abnormal magnetic resonance (MR) imaging findings in the deep digital flexor tendon (DDFT) and distal sesamoid bone in horses with radiographic changes compatible with navicular syndrome. Thirteen postmortem specimens were examined using a 1.5-T magnetic field, with spin echo (SE) T1-weighted, turbo SE (TSE) proton density-weighted (with and without fat saturation), and fat saturation TSE T2-weighted sequences. The limbs were then dissected to compare the MR findings with the gross assessment and histologic examination of the DDFT and distal sesamoid bones. Tendonous abnormalit...
Schoonover MJ, Jann HW, Blaik MA.To quantitatively compare 3 commonly used treatments for navicular syndrome (NS) in horses: heel-elevation shoeing alone, heel-elevation shoeing and phenylbutazone administration, heel-elevation shoeing and injection of the distal interphalangeal joint (DIPJ) with triamcinolone acetonide (TA), and all 3 treatments in combination. Methods: 12 horses with NS. Methods: A force plate was used to measure baseline peak vertical ground reaction force (PVGRF) of the forelimbs. Each horse's forelimbs were shod with 3 degrees heel-elevation horseshoes; PVGRF was measured 24 hours and 14 days after shoei...
McGuigan MP, Wilson AM.Horses with navicular disease have an increased load on the navicular bone in early stance. This has been suggested to be a response to pain in the heel region. Seven horses with clinical, radiographic and scintigraphic signs of navicular disease underwent forceplate and kinematic analysis before and after desensitisation of the heel region with a bilateral palmar digital nerve block. The compressive force exerted on the navicular bone during stance, and stride kinematics, were determined in each state. After regional analgesia of the palmar digital nerves (PDNB) the compressive force on the n...
Bentley VA, Sample SJ, Livesey MA, Scollay MC, Radtke CL, Frank JD, Kalscheur VL, Muir P.Failure of functional adaptation to protect the skeleton from damage is common and is often associated with targeted remodeling of bone microdamage. Horses provide a suitable model for studying loading-related skeletal disease because horses are physically active, their exercise is usually regulated, and adaptive failure of various skeletal sites is common. We performed a histologic study of the navicular bone of three groups of horses: (1) young racing Thoroughbreds (n = 10); (2) young unshod ponies (n = 10); and (3) older horses with navicular syndrome (n = 6). Navicular syndrome is a painfu...
Colles CM, Hickman J.Macroscopic, microscopic and radiological examinations of the navicular bones of 83 horses and ponies showed that the navicular bone in the adult horse has 2 principal routes of blood supply. One supply is present at birth, the other develops within the first 2 to 3 years of life, in response to increasing activity. The size of the nutrient foramina, as seen on radiographs, is related to the type, frequency and regularity of work done by the horse. These foramina are normally conical in shape, alteration to a circular, or mushroom-shape being evidence of occlusive vascular disease in the navic...
Wright IM, Douglas J.In recent years much attention has been paid to vascular studies of the navicular bone in health and disease; however, the relative importance of these studies has overshadowed biomechanical factors which may yet prove to be of importance. This paper outlines the pertinent anatomy, and discusses current concepts in the aetiology and pathogenesis of the disease. It describes the treatment regimens which are based on biomechanical considerations and compares the results of some currently employed techniques. All aspects of navicular disease remain controversial. This paper is not intended to rev...
Ostblom L, Lund C, Melsen F.A histological investigation of navicular bones from 8 horses with navicular disease was carried out to investigate the aetiology of the radiological findings. Two of the horses were double labelled with tetracycline before slaughter in order to assess the vitality of the diseased navicular bone. The examinations revealed no evidence of loss of vitality in the diseased bone areas or in surrounding tissues. A very high rate of remodelling indicated by resorption and formation of bone was present in all cases. This was shown microscopically by the high number of osteoclasts and osteoblasts prese...
Dik KJ, van den Broek J.From progeny lists of 30 Dutch Warmblood sires, 586 3-year-old females by these stallions were randomly selected, each progeny group aimed at 20 animals for statistical reasons. The front feet of the sires and female progeny were examined radiographically using lateromedial and dorsopalmar upright pedal projections. The radiological features associated with navicular disease were classified 0-4 using a standardised classification, grades 3 and 4 representing the more severe changes. The shape of the proximal articular border of the navicular bone outline on the dorsopalmar view was classified ...
Pleasant RS, Moll HD, Ley WB, Lessard P, Warnick LD.To determine if intra-articular anesthesia of the distal interphalangeal joint could alleviate lameness associated with the navicular bursa in horses. Methods: Experimental investigation. Methods: Six clinically normal horses. Methods: Lameness was induced in each horse by injecting either the left or right front navicular bursa with 5 mg of amphotericin-B. Forty-eight hours later each horse was videotaped walking and trotting before, and 5, 30, and 60 minutes after injecting the distal interphalangeal joint of the treated limb with 5 mL of 2% mepivacaine hydrochloride. All video recordings we...
Gutierrez-Nibeyro SD, White Ii NA, Werpy NM.Currently, there are limited data regarding the long-term outcome of horses with foot pain treated with corrective shoeing, rest and rehabilitation, and intrasynovial anti-inflammatory medication to target lesions detected with MRI. Objective: To report the long-term (≥12 months) outcome of horses with foot lesions following medical therapy. Objective: 1) There is no association between clinical parameters considered and a poor response to therapy. 2) Horses with a deep digital flexor tendinopathy are less likely to respond to medical therapy than horses without a deep digital flexor tendino...
Sampson SN, Schneider RK, Gavin PR, Ho CP, Tucker RL, Charles EM.Seventy-two horses with recent onset of navicular syndrome and normal radiographs were assessed. Horses underwent magnetic resonance (MR) imaging of both front feet. All abnormalities were characterized and the most severe abnormality identified, if possible. Abnormal signal intensity in the navicular bone was the most severe abnormality in 24 (33%) horses. Pathologic change in the deep digital flexor tendon was the most severe abnormality in 13 (18%) horses. Pathologic change in the collateral sesamoidean ligament was the most severe abnormality in 11 (15%) horses. Pathologic change in the di...
Turner TA.Navicular disease was diagnosed in 36 horses. Each horse was treated, using shoeing as the only major means of treatment. Phenylbutazone was used initially for 10 days after shoeing. Shoeing was designed to correct preexisting problems, enhance physiologic function of the foot, and ease breakover of the foot. The horses were evaluated over a period ranging from 12 to 54 months. The lameness improved in all horses. Thirty-one of the 36 horses treated were not lame when last evaluated. Shoeing was most effective when performed within 8 months of the first signs of lameness. Also, horses used for...
Bowker RM, Atkinson PJ, Atkinson TS, Haut RC.To examine articular cartilage of the distal interphalangeal (DIP) joint and distal sesamoidean impar ligament (DSIL) as well as the deep digital flexor tendon (DDFT) for adaptive responses to contact stress. Methods: Specimens from 21 horses. Methods: Pressure-sensitive film was inserted between articular surfaces of the DIP joint. The digit was subjected to a load. Finite element models (FEM) were developed from the data. The navicular bone, distal phalanx, and distal attachments of the DSIL and DDFT were examined histologically. Results: Analysis of pressure-sensitive film revealed signific...
