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.
Hunter BG, Duesterdieck-Zellmer KF, Larson MK.Anecdotal accounts of tiludronate administration via intravenous regional limb perfusion (IVRLP) exist despite a lack of information regarding safety for synovial structures in the perfused area. The objective of this study was to determine whether tiludronate concentrations in synovial structures after IVRLP with low dose (0.5 mg, LDT) or high dose (50 mg, HDT) tiludronate remain below a value demonstrated in vitro to be safe for articular cartilage (<19,000 ng/ml), and to determine effects of tiludronate on synovial fluid cytology variables compared to saline perfused control limbs. Using...
McGill SL, Gutierrez-Nibeyro SD, Schaeffer DJ, Hartman SK, O'Brien RT, Joslyn SK.Abnormalities of the deep digital flexor tendon, navicular bone, and collateral sesamoidean ligament can be difficult to visualize using magnetic resonance imaging (MRI) if bursal fluid is absent. The use of saline podotrochlear bursography improves podotrochlear apparatus evaluation, however, the technique has disadvantages. The objective of this prospective feasibility study was to describe saline arthrography of the distal interphalangeal joint as an alternative technique for improving MRI visualization of the deep digital flexor tendon, navicular bone, collateral sesamoidean ligament, and ...
de Zani D, Polidori C, di Giancamillo M, Zani DD.There are few studies on the correlations between radiographic measurements of the foot and abnormalities of specific structures found with magnetic resonance imaging (MRI). Objective: To document the relationship between radiographic measurements of the equine foot and the presence of lesions in the foot on MRI. We hypothesised that different radiographic measurements would be associated with specific lesions detected by MRI. Methods: Retrospective analysis of radiographs and MRI studies. Methods: Seventy-four feet from 52 lame horses were included. Twenty parameters were measured on radiogra...
Daniel AJ, Goodrich LR, Barrett MF, Werpy NM, Morley PS, McIlwraith CW.Injection of the navicular bursa is commonly performed from the palmar aspect of the limb, which results in penetration of the deep digital flexor tendon (DDFT). Objective: To report a radiographic guided injection from the lateral aspect of the limb that avoids puncture of the DDFT and to assess synovial and soft tissue penetration by the needle. Methods: Prospective clinical and cadaveric study. Methods: Prospective analysis of cadaver limbs and clinical cases in which the navicular bursa was injected from the lateral aspect. Cadaver limbs were placed in a stand to simulate weight bearing an...
Parkes R, Newton R, Dyson S.Previous descriptions of the clinical features of navicular disease occurred before the widespread use of magnetic resonance imaging (MRI) allowed a more definitive diagnosis of foot pain. The objective of this study was to compare the clinical features of horses with lesions of the podotrochlear apparatus with those with other causes of foot pain. It was hypothesised that primary navicular bone disease would be associated with more advanced radiological findings than other diagnoses. A retrospective study was performed of all horses examined at a referral centre with a definitive diagnosis of...
Gutierrez-Nibeyro SD, Santos MP, White NA, Brown JA, Adams MN, McKnight AL, Schaeffer DJ.To determine the safety and short-term efficacy of intrabursal administration of botulinum toxin type B (BTXB) to alleviate lameness in horses with degenerative injury to the podotrochlear apparatus (PA). Methods: 10 Quarter Horses with degenerative injury to the PA. Methods: Degenerative injury to the PA was confirmed with diagnostic analgesia and imaging. Then, BTXB (3.8 to 4.5 U/kg) was injected into the podotrochlear (navicular) bursa of each horse. Three horses were used in a safety evaluation. Subsequently, video recordings of lameness evaluations were obtained for 7 client-owned horses ...
Yorke EH, Judy CE, Saveraid TC, McGowan CP, Caldwell FJ.Distal border fragments of the navicular bone are increasingly being detected due to the improved capabilities of magnetic resonance imaging (MRI), but their clinical significance remains unclear. The purpose of this retrospective study was to describe the location, size, and frequency of fragments in a cohort of horses presented for MRI of the foot and to compare MRI findings with severity of lameness. Archived MRI studies and medical records were searched from March 2006 to June 2008. Horses were included if a distal border fragment of the navicular bone was visible in MRI scans. Confidence ...
Komosa M, Purzyc H, Fraackowiak H.The main aim of the study was to compare the shape of navicular bones classified as normal and pathologically changed. A comparison of metric features of the navicular bone between different types of horses and associating the examined parameters to the size of the middle and distal phalanges was an additional aspect of the study. The material comprised 53 horses of various breeds which were divided into three types. Through anatomical examinations it was concluded that as many as 30 navicular bones were normal, while 23 were found to present pathological changes. The following methods of stat...
Young AC, Dimock AN, Puchalski SM, Murphy B, Spriet M.Osseous resorption of the flexor surface of the distal phalanx of the horse has been identified previously using magnetic resonance (MR) imaging; however, little is known about the prevalence and characteristics of this lesion. Objective: To establish the MR prevalence of resorptive lesions in the flexor surface of the distal phalanx and identify concurrent lesions associated with this finding and associations between the MR and radiographic findings. Methods: Horses with distal extremity MR and radiographs performed within 2 weeks of each other were included in the study. The flexor surface o...
Olive J, Vila T, Serraud N.To compare navicular bone marrow lesion (BML) conspicuity in the feet of horses as determined via 2 fat-suppressed MRI techniques, including standard short tau inversion recovery (STIR) and inversion recovery gradient echo (IRGE). Methods: Feet (n = 150) of horses with lameness referable to the distal portion of the digit. Methods: STIR and IRGE sequences were obtained prospectively in all feet with a standing low-field equine MRI system. Presence of a BML was ascertained by identification of a characteristic combination of marrow alterations in T1-weighted, T2*-weighted, T2-weighted, and STIR...
Biggi M, Dyson S.The distribution of lesions detected using magnetic resonance imaging (MRI) of hind feet has not been reported. Objective: To evaluate type and distribution of lesions detected using MRI in hind feet of lame horses and to compare the findings with those reported in front feet; to document follow-up information. Methods: Horses were selected if hindlimb lameness was abolished by plantar nerve blocks performed at the base of the proximal sesamoid bones. Magnetic resonance images were acquired using either a low-field or a high-field magnet, and all images were evaluated retrospectively by both a...
Marsh CA, Schneider RK, Sampson SN, Roberts GD.To determine treatment outcome on the basis of pathological changes identified on MRI and lameness duration in horses with navicular syndrome that underwent injection of corticosteroid and hyaluronan into the navicular bursa. Methods: Retrospective case series. Methods: 101 horses with navicular syndrome. Methods: Medical records of horses with signs of navicular syndrome evaluated between January 2000 and December 2008 were reviewed. Data on signalment, use of the horse, history, affected limbs, duration of lameness, findings on lameness examination, radiographic findings, MRI findings, treat...
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...
Holowinski ME, Solano M, Maranda L, García-López JM.Adhesions occur in the navicular bursa between the deep digital flexor tendon (DDFT) and other structures. Our objectives were to describe the appearance of navicular bursa adhesions on high-field magnetic resonance (MR) images, to compare these findings to findings at navicular bursoscopy, and to determine the prevalence of lesions in the remainder of the podotrochlear apparatus. Sixteen forelimbs from 14 horses that underwent MR imaging and navicular bursoscopy were evaluated. Adhesions were considered type 1 when characterized by a discontinuity in the navicular bursa fluid signal between t...
Dyson S, Blunden T, Murray R.There is limited knowledge about both histological features in early navicular disease and what histological features are represented by increased signal intensity in fat-suppressed magnetic resonance (MR) images of the navicular bone. Objective: To characterise increased signal intensity in the spongiosa of the navicular bone in fat-suppressed MR images and to compare this with histopathology; and to compare objective grading of all aspects of the navicular bone on MR images with histological findings. Methods: One or both front feet of 22 horses with foot pain and a median lameness duration ...
Gutierrez-Nibeyro S, Werpy N, White Ii N.Conventional imaging modalities can diagnose the source of foot pain in most cases, but have limitations in some horses, which can be overcome by using magnetic resonance imaging (MRI). However, there are no reports of the MRI appearance and prevalence of foot lesions of a large series of horses with chronic foot lameness. Methods: In the present study, 79 horses with unilateral or bilateral forelimb lameness because of chronic foot pain underwent standing low-field MRI to make a definitive diagnosis. Results: Of the 79 horses, 74 (94%) had alterations in >1 structure in the lame or lamest foo...
Claerhoudt S, Bergman HJ, Van Der Veen H, Duchateau L, Raes EV, Saunders JH.Distal border synovial invaginations of the distal sesamoid bone are radiographically assessed during the selection process of horses admitted as breeding stallions or in purchase examinations. Nowadays, many moderately or some deeply penetrating proximally enlarged synovial invaginations are considered as moderate or severe radiographic findings. Objective: To measure the difference between and agreement of the morphology of distal border synovial invaginations on radiography vs. computed tomography (CT). It was hypothesised that the morphology of distal border synovial invaginations would be...
Waguespack RW, Hanson RR.Navicular syndrome is a chronic, progressive condition affecting the navicular bone and bursa, deep digital flexor tendon (DDFT), and associated soft tissue structures composing the navicular apparatus. The treatment options for navicular syndrome are as varied as the proposed causes of the condition. The severity of clinical signs, intended use and workload of the horse, and owner compliance with therapy are important considerations in developing a treatment plan. Nonsurgical treatment of navicular syndrome consists of rest, hoof balance and corrective trimming/shoeing, and medical therapy, i...
Smith MR, Wright IM.Diagnostic navicular bursoscopy has been described in limited cases. Review of greater numbers is needed to define its contribution to case management and prognostic values. Objective: To report: 1) clinical, diagnostic and endoscopic findings in a series of cases, 2) surgical techniques and case outcomes and 3) prognostic values. The authors hypothesise: 1) lameness localising to the navicular bursa is commonly associated with dorsal border deep digital flexor tendon (DDFT) lesions, 2) endoscopy allows extent of injuries to be assessed and treated, 3) case outcome relates to severity of DDFT ...
Biggi M, Dyson S.The significance of distal border fragments of the navicular bone is not well understood. There are also no objective data about changes in thickness and proximal/distal extension of the palmar cortex of the navicular bone. Objective: To describe the distribution of distal border fragments and their association with other radiological abnormalities of the navicular bone and describe the shape of the navicular bone in sound horses and horses with foot-related lameness, including navicular pathology. Methods: Sound horses had radiographs acquired as part of a prepurchase examination. Lame horses...
Vallance SA, Bell RJ, Spriet M, Kass PH, Puchalski SM.To date, few reports exist comparing magnetic resonance imaging (MRI) and computed tomography (CT) for imaging of the equine distal limb, yet clinicians are required to decide which modality to use regularly. Objective: To report and compare anatomic visualisation scores obtained for CT, contrast enhanced CT (CECT) and standing low-field MRI (LFMRI) in the equine foot. Objective: Anatomic visualisation score discrepancies would exist between CT, CECT and LFMRI. Methods: Images of 22 lame horses (31 limbs) undergoing both CT and LFMRI of the foot were reviewed. When available, CECT images were ...
Maher MC, Werpy NM, Goodrich LR, McIlwraith CW.Magnetic resonance (MR) imaging is often performed to determine the cause of palmar heel pain. We evaluated how distension of the navicular bursa affected the MR appearance of the navicular bursa and associated structures. An MR evaluation was performed on normal cadaver limbs and cadaver limbs from horses with lameness localized to the foot. The normal navicular bursae were injected with 2, 4, or 6 ml of solution. The bursae of the feet from lame horses were injected with 4 or 6 ml, and the MR study was repeated. All bursae were examined grossly to verify the presence or absence of adhesions....
Biggi M, Dyson S.Distal border fragments of the navicular bone can be seen in lame and nonlame horses and their clinical significance remains open to debate. Objective: To describe the magnetic resonance imaging (MRI) appearance of distal border fragments and the adjacent navicular bone. To investigate the relationship between fragments and other abnormalities of the navicular bone and the distal sesamoidean impar ligament (DSIL). Methods: Horses were included if pain causing forelimb lameness was localised to the foot and high-field MR images were acquired. The size and location of distal border fragments wer...
Rabba S, Bolen G, Verwilghen D, Salciccia A, Busoni V.Foot pain is an important cause of lameness in horses. When horses with foot pain have no detectable radiographic abnormalities, soft-tissue assessment remains a diagnostic challenge without magnetic resonance (MR) imaging. Ultrasonography can provide an alternative to MR imaging when that modality is not available but the extent of changes that might be seen has not been characterized. We reviewed the ultrasonographic findings in 39 horses with lameness responding positively to anesthesia of the palmar digital nerves and without radiographically detectable osseous abnormalities. Thirty of the...
Claerhoudt S, Pille F, Vanderperren K, Hauspie S, Duchateau L, Van der Vekens E, Saunders JH.To investigate whether in navicular bones (NB) from warmbloods, distal border fragmentation is associated with the shape of the proximal articular border or other radiological findings. Methods: Radiographs of the front feet of 325 normal, subadult horses presented for admission as breeding stallions were reviewed. Results: The proximal articular border of the total of 650 NB was classified as straight (n = 278), convex (n = 184), undulating (n = 147) or concave (n = 41). Distal border fragments were present in 57 NB (8.8%). They were significantly more prevalent in NB with a concave (9/41; 22...
Jenner F, Kirker-Head C.To determine the physiologic response of the equine navicular bone to core decompression surgery in healthy horses. Methods: Experimental in vivo study. Methods: Healthy adult horses (n=6). Methods: Core decompression was completed by creating three 2.5-mm-diameter drill channels into the navicular bone under arthroscopic control. The venous (P(V)), arterial (P(A)), articular (P(DIPJ)), and intraosseous pressures (IOP) were recorded before and after decompression drilling. Each IOP measurement consisted of a baseline (IOP(B)) and a stress test (intramedullary injection of saline solution, IOP(...
Jenner F, Kirker-Head C.To determine the effect of core decompression surgery and bone mineral density (BMD) on the mechanical properties of equine navicular bones. Methods: Experimental, in vitro study. Methods: Fore limb navicular bones (n=36 pairs) from sound 2-5-year-old horses with no radiographic abnormalities of the distal aspect of the forelimbs. Methods: Navicular BMD was measured using dual energy X-ray absorptiometry. One randomly assigned navicular bone from each pair served as control. The contralateral test specimen was allocated to 1 of 6 treatment groups defined by drill bit size (3.2 versus 2.5 mm di...
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...
Lopes MS, Diesterbeck U, Machado Ada C, Distl O.Navicular disease is characterized by a progressive degenerative alteration of the equine podotrochlea. In this study, we refined a previously identified quantitative trait locus (QTL) on horse chromosome 10 for the abnormal development of canales sesamoidales (DCS) of the navicular bone in Hanoverian warmblood horses. Genotyping was done in 192 Hanoverian warmblood horses from 17 paternal half-sib groups. The whole marker set comprised 45 markers including seven newly developed microsatellites and 13 single nucleotide polymorphisms (SNPs) within positional candidate genes. Chromosome-wide sig...
Biggi M, Dyson S.There are no data concerning the accuracy of conventional and computed or digital radiography for evaluation of the equine foot. Objective: To compare conventional film-screen and computed radiography with magnetic resonance imaging (MRI) for detection of distal border fragments of the navicular bone; and to establish which type of fragment was more likely to be detected radiologically. Methods: Horses were included if forelimb lameness was localised to the foot and both radiography and high-field MR images had been acquired. Horses were divided into 2 groups based on acquisition of convention...
Whitton RC, Buckley C, Donovan T, Wales AD, Dennis R.A cadaver limb from an eight-year-old horse with right forelimb lameness that was relieved with an intra-articular distal interphalangeal joint block was imaged with radiographs, spiral computed tomography (CT) and magnetic resonance imaging (MRI). Spiral CT demonstrated several lucencies within the deep digital flexor tendon immediately proximal to the navicular bone. On MRI these areas had increased signal and there was enlargement of the tendon at this site. Effusion in the proximal interphalangeal joint and navicular bursa and thinning of the fibrocartilage of the navicular bone were also ...
Waguespack RW, Hanson RR.Navicular syndrome is a chronic, progressive condition affecting the navicular bone and bursa, deep digital flexor tendon (DDFT), and associated soft tissue structures composing the navicular apparatus. The treatment options for navicular syndrome are as varied as the proposed causes of the condition. The severity of clinical signs, intended use and workload of the horse, and owner compliance with therapy are important considerations in developing a treatment plan. Nonsurgical treatment of navicular syndrome consists of rest, hoof balance and corrective trimming/shoeing, and medical therapy, i...
Parkes R, Newton R, Dyson S.Previous descriptions of the clinical features of navicular disease occurred before the widespread use of magnetic resonance imaging (MRI) allowed a more definitive diagnosis of foot pain. The objective of this study was to compare the clinical features of horses with lesions of the podotrochlear apparatus with those with other causes of foot pain. It was hypothesised that primary navicular bone disease would be associated with more advanced radiological findings than other diagnoses. A retrospective study was performed of all horses examined at a referral centre with a definitive diagnosis of...
Wright IM.The clinical features are reported from 118 horses (mean age 9.2 years) which were diagnosed as suffering from navicular disease using predetermined criteria. The animals were used for a variety of purposes and had been lame for periods between 1 and 72 months. The majority of cases (84.7%) had been treated using various techniques before evaluation. The severity of lameness was related to the duration of clinical signs: 78% of horses were bilaterally affected but there was no left:right limb predominance. Broken foot/pastern axes were recorded in 75% of horses while 45% also exhibited mediola...
Marsh CA, Schneider RK, Sampson SN, Roberts GD.To determine treatment outcome on the basis of pathological changes identified on MRI and lameness duration in horses with navicular syndrome that underwent injection of corticosteroid and hyaluronan into the navicular bursa. Methods: Retrospective case series. Methods: 101 horses with navicular syndrome. Methods: Medical records of horses with signs of navicular syndrome evaluated between January 2000 and December 2008 were reviewed. Data on signalment, use of the horse, history, affected limbs, duration of lameness, findings on lameness examination, radiographic findings, MRI findings, treat...
Bowker RM, Van Wulfen KK, Springer SE, Linder KE.To examine macro- and microscopic characteristics of cartilage of the distal phalanx (ungual cartilage [UC]) and digital cushion in the equine foot and to relate them to the foot's function of energy dissipation. Methods: 85 horses and 5 foals of various breeds and ages. Methods: Feet, obtained at necropsy, were perfused with India ink (n = 30), latex (5), or polymer plastic (10). Select feet were examined histologically for tissue architecture and to identify elastic fibers. Immunochemistry to identify substance P peptides in nerves (feet from foals) and gold chloride impregnation of axons (n...
Widmer WR, Buckwalter KA, Fessler JF, Hill MA, VanSickle DC, Ivancevich S.Radiographic evaluation of navicular syndrome is problematic because of its inconsistent correlation with clinical signs. Scintigraphy often yields false positive and false negative results and diagnostic ultrasound is of limited value. Therefore, we assessed the use of computed tomography and magnetic resonance imaging in a horse with clinical and radiographic signs of navicular syndrome. Cadaver specimens were examined with spiral computed tomographic and high-field magnetic resonance scanners and images were correlated with pathologic findings. Radiographic changes consisted of bony remodel...
Turner TA, Fessler JF, Lamp M, Pearce JA, Geddes LA.The distal forelimbs of 10 clinically normal horses with hair clipped on 1 limb were thermographically scanned before and after exercise. The thermal patterns, temperature distribution, and temperature changes after exercise were determined and compared with those of 8 horses with podotrochlosis. Clipping the hair did not cause changes in the thermal patterns, but the clipped limbs were warmer than the unclipped limbs. The temperature of the limbs of horses with podotrochlosis did not increase as much after exercise as did the limbs of normal horses. The failure of skin temperature increase co...
Svalastoga E, Smith M.The subchondral bone pressure in the navicular bone of horses with navicular disease is compared with corresponding pressures in normal horses. An increased intraosseous pressure and a lengthened pressure drop time was demonstrated in patients with navicular disease, which indicates the existence of a venous stasis. Compared with similar investigations in humans with arthrosis it is concluded that navicular disease is a condition resembling arthrosis. The classical clinical symptoms are explained as an expression of resting pains. Treatments are suggested which theoretically can render the pat...
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...
Dyson SJ.It was hypothesised that in solar bone images of the front feet of clinically normal horses, or horses with lameness unrelated to the front feet, there would be less than a 10% difference in the ratio of uptake of radiopharmaceutical in either the region of the navicular bone, or the region of insertion of the deep digital flexor tendon (DDFT), compared to the peripheral regions of the distal phalanx. Nuclear scintigraphic examination of the front feet of 15 Grand Prix show jumping horses, all of which were free from detectable lameness, was performed using dorsal, lateral and solar images. Th...
Johnson SA, Barrett MF, Frisbie DD.Radiographic flexor cortical lysis indicates advanced degenerative change and its earlier recognition may improve case outcome. Aims of this prospective, diagnostic accuracy study were to determine effects of radiographic beam angle and observer on accuracy of lesion detection. The sample included 36 limbs from 31 horses. Palmaroproximal-palmarodistal oblique (skyline) radiographs were acquired at standard (n = 38) and more shallow (alternate) angles (n = 58). Images were independently reviewed by four experience levels of five observers each (n = 20) for the presence and severity of fle...
Dyson SJ, Kidd L.Analgesia of the distal interphalangeal (DIP) joint and of the navicular bursa was performed independently in the lame or lamer forelimb of 59 horses, in which lameness was significantly improved by perineural analgesia of either the palmar digital or palmar (abaxial sesamoid) nerves. In 3 horses no improvement was detected. Lameness was improved by analgesia of the DIP joint but there was no response to analgesia of the navicular bursa in 3 horses. In 12 horses, lameness was improved by analgesia of the navicular bursa but intra-articular analgesia resulted in no change. Forty-one horses resp...
Rijkenhuizen AB.The 21st century has heralded a reassessment of our ideas about
navicular disease. In particular, the proposal of different
pathological entities has led to alternative treatment regimes and a
sounder basis for reaching a prognosis. Further, recently generated
data have given grounds for reconsidering both terminology and
treatment. The impact of recent information on the clinical
approach to suspected navicular disease of concepts relating to
diagnostic analgesia, the evolution of diagnostic imaging
techniques, biomarkers, biomechanics and heritability require
placing into the contex...
Németh F, Dik KJ.A sagittal fracture of the navicular bone in five horses was treated by means of lag screw. Intra-operative radiographic monitoring and a specially developed guide apparatus was necessary to implant the screw precisely along the transverse axis of the navicular bone. Internal fixation resulted in progressive radiographic narrowing of the fracture zone. In all five patients the fracture healed (bony union) without superfluous callus formation.
Ostblom LC, Lund C, Melsen F.Although the diagnostic criteria of navicular disease are generally accepted in practice, their limitations are recognised. However, the authors believe that navicular disease per se is reversible and that only secondary changes like adhesions to the deep flexor tendon or spur formations are irreversible. This hypothesis is supported by the results presented of the effect of the application of an egg-bar shoe, which caused permanent cessation of signs of navicular disease in more than 50 per cent of treated cases. The egg-bar shoeing technique can be usefully applied in practice.
Claerhoudt S, Bergman HJ, Van Der Veen H, Duchateau L, Raes EV, Saunders JH.Distal border synovial invaginations of the distal sesamoid bone are radiographically assessed during the selection process of horses admitted as breeding stallions or in purchase examinations. Nowadays, many moderately or some deeply penetrating proximally enlarged synovial invaginations are considered as moderate or severe radiographic findings. Objective: To measure the difference between and agreement of the morphology of distal border synovial invaginations on radiography vs. computed tomography (CT). It was hypothesised that the morphology of distal border synovial invaginations would be...
Leach DH.The future directions of navicular disease research are unclear. Often researchers investigate only one of the multitude of factors likely to be important in understanding the disease. Two exceptions to this is work done by Wright in this issue of EVJ and by MacGregor (1988) who compared a number of the treatment regimens (e.g. rest, warfarin, isoxsuprine, shoeing with egg bars) and found that approximately 75% of the horses improved in their performance. Perhaps this percentage of 'recovered' horses from this disease is what can be realistically expected, as often horses with navicular diseas...
Symonds KD, MacAllister CG, Erkert RS, Payton ME.To evaluate the musculoskeletal analgesic effect of etodolac administered PO every 12 or 24 hours in chronically lame horses by use of force plate analysis. Methods: 22 horses with navicular syndrome. Methods: Horses received etodolac (23 mg/kg, PO, q 12 h; n = 7), etodolac (23 mg/kg, PO, q 24 h; 8), or corn syrup (20 mL, PO, q 24 h; control treatment; 7) for 3 days. Combined forelimb peak vertical ground reaction force (PVF) was measured via force plate analysis before the first treatment (baseline) and at 6, 12, 24, and 36 hours after the last treatment. Differences in mean PVF (mPVF) betwee...
Schumacher J, Schumacher J, Gillette R, DeGraves F, Schramme M, Smith R, Perkins J, Coker M.Analgesia of the palmar digital (PD) nerves has been demonstrated to cause analgesia of the distal interphalangeal (DIP) joint as well as the sole. Because the PD nerves lie in close proximity to the navicular bursa, we suspected that that analgesia of the navicular bursa would anaesthetise the PD nerves, which would result in analgesia of the DIP joint. Objective: To determine the response of horses with pain in the DIP joint to instillation of local anaesthetic solution into the navicular bursa. Methods: Lameness was induced in 6 horses by creating painful synovitis in the DIP joint of one f...
Vacek JR, Welch RD, Honnas CM.An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between t...
Harper J, Schumacher J, Degraves F, Schramme M, Schumacher J.Specific analgesic techniques are required in diagnosis of lameness to isolate the exact origin of pain to the many structures of the foot that may be involved. Objective: To determine if analgesia of the digital flexor tendon sheath (DFTS) results in anaesthesia of other portions of the foot, such as the sole, distal interphalangeal joint (DIPJ), or navicular bursa (NB). Methods: Lameness caused by pain in the dorsal margin or heel region of the sole of the foot was induced in 18 horses by: using set-screws to create solar pressure (Trial 1: n = 5); or administering endotoxin intrasynovially ...
Martin GS, McIlwraith CW, Turner AS, Nixon AJ, Stashak TS.A retrospective study was made of 21 horses in which proximal interphalangeal arthrodesis had been performed. The right hindlimb was the most often affected (52%). Acute trauma was the most common reason for performing the surgery (62%). Follow-up data were obtained from the owners regarding return to serviceability . When available, follow-up radiographs and clinical examinations were reviewed. Of the 20 horses on which follow-up information was available, 16 were serviceable . Of the horses in which a hindlimb was arthrodesed , 86% were serviceable , whereas 67% of the horses affected in the...
Wright IM, Phillips TJ, Walmsley JP.A technique for evaluation of the navicular bursa using a 4 mm 25 degrees inclined view arthroscope is described. This allows examination of the palmar/plantar surface of the navicular bone, the insertions of the navicular suspensory, T and impar ligaments, the bursal synovium and the dorsal surface of the deep digital flexor tendon. The technique was used in 16 horses with punctures of the navicular bursa. Procedures facilitated by the technique were bursal lavage, removal of pannus, synovial resection and debridement of lesions on the palmar/plantar surface of the bone and in the deep digita...
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...
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...
Reeves MJ, Yovich JV, Turner AS.The etiology, clinical presentation, radiographic findings, diagnostic criteria, differential diagnoses, treatment, and prognosis are reviewed for several clinically important conditions of the equine foot. These include pedal osteitis, sheared heels, distal sesamoid bone (navicular) fractures, subchondral bone cyst of the distal phalanx, distal interphalangeal joint subluxation, congenital phalangeal hypoplasia, bipartite and tripartite distal sesamoid bones, keratoma, ossification of the cartilages of the distal phalanx (sidebones), necrosis of the cartilages of the distal phalanx (quittor),...
Schramme MC, Boswell JC, Hamhougias K, Toulson K, Viitanen M.Numerous different techniques for injection of the navicular bursa have been described but there is little conformity between these descriptions. A literature review was performed and techniques for injection of the navicular bursa were categorised into 5 approaches. This study was performed to evaluate the reproducibility of each technique and to assess which technique was consistently most successful. Five inexperienced operators performed each technique on 5 cadaver forelimbs. Once a needle had been placed, a radiograph was taken to confirm placement was in accordance with the description o...
Pauwels FE, Schumacher J, Castro FA, Holder TE, Carroll RC, Sega GA, Rogers CW.To determine whether clinically effective concentrations of methylprednisolone or triamcinolone can be achieved in the navicular bursa after injection of methylprednisolone acetate (MPA) or triamcinolone acetonide (TA) into the distal interphalangeal joint (DIPJ) and whether clinically effective concentrations of these drugs can be achieved in the DIPJ after injecting the navicular bursa with the same doses of MPA or TA. Methods: 32 healthy horses. Methods: Horses in groups 1 through 4 received 40 mg of MPA in the DIPJ, 10 mg of TA in the DIPJ, 40 mg of MPA in the navicular bursa, and 10 mg of...
McGill SL, Gutierrez-Nibeyro SD, Schaeffer DJ, Hartman SK, O'Brien RT, Joslyn SK.Abnormalities of the deep digital flexor tendon, navicular bone, and collateral sesamoidean ligament can be difficult to visualize using magnetic resonance imaging (MRI) if bursal fluid is absent. The use of saline podotrochlear bursography improves podotrochlear apparatus evaluation, however, the technique has disadvantages. The objective of this prospective feasibility study was to describe saline arthrography of the distal interphalangeal joint as an alternative technique for improving MRI visualization of the deep digital flexor tendon, navicular bone, collateral sesamoidean ligament, and ...
