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.
Ostblom L, Lund C, Melsen F.Twelve horses suffering from navicular bone disease were examined in a prospective, controlled histomorphometric study for six months. The objective was to compare the histology of navicular bones from untreated animals to those treated with the egg-bar shoeing technique. These data were compared to similar sections from three normal animals. The current investigation provided quantitative support to previous findings concerning clinical improvement. Detailed histology, changes in bone morphometry and pathophysiological reactions are discussed.
Rijkenhuizen AB, Németh F, Dik KJ, Goedegebuure SA.A macroscopic, arteriographic and histological study of the development and the arterial anatomy of the navicular bone of 33 foetuses and 55 young horses is described. After 125 days of gestation the blood supply consists of two routes: one situated in the superficial layer of the fibrocartilage and the other similar to the blood supply of the navicular bone of the normal mature horse. After 270 days gestation, the blood vessels in the fibrocartilage gradually regressed and retracted until they have disappeared at six months after birth. At two months after birth the first macroscopic thinning...
Rijkenhuizen AB, Németh F, Dik KJ, Goedegebuure SA.A macroscopical, arteriographical and histological study was made of the arterial supply of the navicular bones of horses with clinical and/or radiographic signs of navicular disease. Based on the clinical and radiological findings the navicular bones of 40 Warmblood horses are divided into four different groups. In the pattern of the arteriogram obvious changes are noticed: an imbalance and a distal to proximal shift between the distal and proximal arterial supply occur, indicating a reduction of the distal blood supply with a compensatory reaction of the proximal, medial and lateral supply. ...
Rijkenhuizen AB, Németh F, Dik KJ, Goedegebuure SA, Van de Brom WE.The clinical, radiographic, arteriographic, scintigraphic and histological effects of experimental occlusion of the Ramus navicularis (R. Navicularis) and its branching arteries are evaluated. Occlusion of the R. navicularis and its branching arteries creates changes, arteriographically and histologically, which resemble those of navicular disease. The increased bone remodelling, the shift in arterial pattern, the formation of collaterals and the increased connective tissue in the synovial membrane and nutrient foramina, as a reaction to the reduction of the distal arterial supply of the navic...
Rijkenhuizen AB, Nemeth F, Dik KJ, Goedegebuure SA.An arteriographic and histological study of the arterial blood supply of 35 navicular bones, from 19 adult horses with no clinical or radiographical signs of navicular disease, is described. The arteries enter the navicular bone from four directions: distal, proximal, medial, and lateral. The navicular bone can be divided into areas which receive arteries from one, two, or three directions, whereas the distal supply covers the largest part of the navicular bone. The distal arteries enter the navicular bone through the nutrient foramen which contains loose connective tissue, nutrient vessels an...
Rijkenhuizen AB, Nèmeth F, Dik KJ, Goedegebuure SA, Van den Brom WE.Clinical, radiographical, scintigraphical and histological effects on the navicular bone after resection of the medial and lateral palmar digital arteries in the pastern of one forelimb in ponies are evaluated. The acute disruption of the main blood supply of the distal extremity causes lameness due to the suddenness of the resection in which the collateral circulation is insufficiently developed. Because of the compensatory collateral circulation, no permanent symptoms of ischaemia occur despite the partial resection of both palmar digital arteries. Histologically the percentage of relative o...
Turner AS, Tucker CM.A randomised double-blind clinical trial of 28 horses was undertaken to evaluate the efficacy of isoxsuprine hydrochloride at four different doses:- 0.0 mg/kg bodyweight (bwt) (placebo), 0.6 mg/kg bwt, 1.2 mg/kg bwt and 1.8 mg/kg bwt for treatment of navicular disease. The results showed that horses treated with isoxsuprine hydrochloride (N = 22) responded significantly with respect to clinical assessment score (P less than 0.01) when compared with the control group (N = 6). Furthermore, there were no dose-related differences in the responses of the horses treated with increasing levels of iso...
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...
Turner TA.Navicular syndrome can be treated in a variety of ways. This is related to the fact that it has a variety of causes. Prognostically, most horses will improve with treatment. One can expect about 50 per cent of the horses to become useably sound for 1 year, no matter what treatment is used. The disease is progressive, and affected horses eventually will need to be retired because of lameness. The author's therapeutic approach is to utilize shoeing as the primary therapy. Shoeing is performed to correct structural problems and to ensure that shoeing is physiologically sound. Nonsteroidal anti-in...
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),...
Hoffer MA, Leach DH, Doige CE.The navicular bone, navicular bursa and their associated structures were collected from 20 horses ranging in age from 80 days gestation to 2 years post-gestation. The right front foot of every horse was sampled for light microscopy. The development of the navicular bursa and associated structures were studied. Study of the developmental anatomy of the equine navicular bursa established that the bursa is a distinct entity in both the fetus and the adult horse. Development of the bursal cavity in the fetus was found to be complete by 120 days of gestation. Synovial membrane of the navicular burs...
Verschooten F, Roels J, Lampo P, Desmet P, De Moor A, Picavet T.Radiographic measurements from the lateromedial projection of the equine foot were compared in three groups of horses. Group 1 consisted of 143 normal horses, group 2 were 60 horses with clinical navicular disease and group 3 were 161 horses with clinical and radiographic navicular disease. Several measurements tended to be larger in group 3 than group 1. An enlargement of the navicular bone was observed in proximodistal and dorsopalmar directions. Partial enlargement of the pedal bone was observed in groups 2 and 3. Few differences were observed between age classes. All horses aged four years...
Fubini SL, Cummings JF, Todhunter RJ.Painful neuroma formation after palmar digital neurectomy in the horse is common. Experimentally, injection of doxorubicin (Adriamycin) into the proximal transected nerve stump has been shown to prevent axon sprouting and neuroma formation for up to 5 months. This procedure was used in 28 horses with navicular disease, preexisting painful neuroma, or wing fractures of the distal phalanx. At 1 month, 16 horses had incisional complications. At 1 year, 15 horses were sound. Eight horses were lame, although three were improved. Three horses required a second surgical procedure, two of which became...
Zweers AD, Dik KJ.The radiographic diagnostic value of Rose's palmaroproximal-dorsodistal ('skyline') projection and Oxspring's dorsopalmar projection of the equine navicular bone were compared, by examining radiographs of 102 navicular bones originating from 66 randomly selected horses with clinical evidence of lameness located in the navicular area. In 27 navicular bones essential information was obtained from the skyline view, 15 independently of Oxspring's projection and 12 in addition to this view. For 11 navicular studies the D.P. projection was the most important diagnostic view. In the other 64 navicula...
Modransky P, Thatcher CD, Welker FH, Booth LC.This research journal article documents a rare case of a five-day-old foal suffering from a congenitally malformed hoof and the associated lameness. The disorders studied were unilateral navicular bone agenesis […]
Wright IM.The technique of navicular suspensory desmotomy for the treatment of navicular disease is described and the rationale behind its development is discussed. To date 16 horses involved in a clinical evaluation of the technique have been assessed six months after surgery. Thirteen of these horses are able to work without lameness.
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...
Amin TM, Sirs JA, Allen BV, Colles CM.A preliminary investigation has been undertaken of blood rheology in horses and ponies, its variation in navicular disease and the changes following treatment with warfarin. Erythrocyte flexibility, measured by a centrifuge packing technique, is higher in horses (30 per cent min-1) than in ponies (23.8 per cent min-1). There are corresponding differences in blood viscosity. The high erythrocyte flexibility in horses is caused by an unknown factor present in plasma. The erythrocyte flexibility in horses with navicular disease is even higher, at 38.5 per cent min-1. Treatment with warfarin reduc...
MacGregor CM.Radiographic examination of the navicular bones of 258 horses was carried out. Of these 258 horses, 83 were sound (Group A), 151 had been diagnosed clinically as having navicular disease (Group B), and 24 had a forefoot lameness of unknown aetiology (Group C). Seven basic shapes of distal nutrient foramina were identified from these radiographs. A scoring system was then developed based on these different types of distal nutrient foramina. When this scoring system was applied to the radiographs of the 258 horses examined significant differences were found between the mean navicular scores of t...
Smith DR, Leach DH, Bell RJ.Anatomical anomalies in the hind feet of a seven month old Appaloosa foal were identified and investigated through the use of gross anatomical dissection, radiography and angiography. Abnormalities were restricted to the distal aspect of both hind legs, the right hind leg being more severely affected. Anatomically the right foot resembled that of an equine fetus of approximately 120 days gestational age. Disruption of vascular perfusion to hoof structures was evident in both hind legs and was related to areas of abnormal bone conformation as well as to areas of abnormal ossification and calcif...
Bos H, van der Meij GJ, Dik KJ.Bone structure, nutrient canals, form and definition, and a total evaluation of both fore navicular bones were radiologically evaluated in 169 three- and four-year-old Dutch warmblood mares divided into eleven daughter (half sister) groups. On the basis of the 'total evaluation', differences between the three- and four-year-old horses were detectable. Using the 'total evaluation', significant differences were found between daughter groups consisting of three-year-old mares. These differences support the theory that podotrochleosis may be (partly) due to the presence of genetic factors. The pos...
van den Bogaard AE, Thijssen HH, Hemker HC.The anticoagulant, warfarin, has been reported to be effective as treatment for navicular disease in horses. Since other forms of treatment for this disease are palliative, this new anticoagulant therapy has become widely employed. Despite the fact that initiation of anticoagulant therapy is relatively simple, attending veterinary practitioners should be aware that careful monitoring of this therapy is required for both safety and efficacy. Navicular disease is an example of equine thrombotic disease, and the goal of warfarin therapy is the prevention of new thrombus formation, while at the sa...
Markel MD, Meagher DM, Ford TS.A 3-month-old Quarter Horse filly stepped on a fence staple and developed navicular bone osteomyelitis of the right hindfoot. A 1.5-cm spherical portion of medullary cavity containing purulent material was debrided and flushed with 0.9% NaCl solution. Cancellous bone was collected from a caudal sternebra and placed into the defect. The solar defect had filled with granulation tissue and was epithelialized 6 weeks after surgery. At 6-month follow-up evaluation, the navicular bone defect had healed and the foal was sound on the limb. Cancellous bone grafting may have merit for the treatment of n...
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.
Bertone AL, Aanes WA.Three cases of unilateral congenital phalangeal hypoplasia are described in 2 horses and 1 mule. Radiographic lesions include severe hypoplasia of the 3rd phalanx, and associated hypoplasia of the 2nd phalanx in 2 cases, and hypoplasia or aplasia of the navicular bone in 2 cases. All animals could ambulate but were lame. Two cases had palpable laxity at the level of the coronary band. Documented etiology was not determined for the dysgenesis, but possibilities include inherited transmission or an environmental teratogen.
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. ...
Doige CE, Hoffer MA.Navicular bones from 74 horses were examined at necropsy. Animals ranged in age from eight months to 30 years. Eight horses had a clinical history of navicular disease. Degenerative lesions in the fibrocartilaginous surface of the navicular bone and of the surface of the deep flexor tendons were age related changes not necessarily related to lameness. These lesions were more extensive in horses with a history of navicular disease, and were often accompanied by adhesions and subchondral cavitation of the fibrocartilaginous surface of the navicular bone. Osteophytes, present in 12 of the 74 hors...
Jimenez MM, Kirker-Head CA, Jakowski RM, O'Callaghan MW.Hypoplasia affecting both hind limbs was observed in a neonatal foal. Scintigraphy aided in establishing diagnosis and prognosis. Radiography revealed an abnormally shaped middle phalanx and lack of the distal phalanx and navicular bone in the right hind limb, with an abnormally shaped distal phalanx and navicular bone in the left hind limb. Scintigraphic findings were closely correlated with the radiographic findings. Radiographic and scintigraphic findings were confirmed at postmortem examination.
Markel MD, Meagher DM, Ford TS.A 3-month-old Quarter Horse filly stepped on a fence staple and developed navicular bone osteomyelitis of the right hindfoot. A 1.5-cm spherical portion of medullary cavity containing purulent material was debrided and flushed with 0.9% NaCl solution. Cancellous bone was collected from a caudal sternebra and placed into the defect. The solar defect had filled with granulation tissue and was epithelialized 6 weeks after surgery. At 6-month follow-up evaluation, the navicular bone defect had healed and the foal was sound on the limb. Cancellous bone grafting may have merit for the treatment of n...
Sardari K, Kazemi H.To evaluation of clinical examination for differential diagnosis of navicular region pain from other forms of palmar heel pain in the forelimb in horses the present study was undertaken. Thirty four horses with lameness referable to the palmar aspect of the hoof based on their response to the palmar digital nerves analgesia were divided into 2 groups based on their response to both distal interphalangeal joint and navicular bursa analgesia. Horses that were profoundly improved by both analgesic blocks (distal interphalangeal joint and navicular bursa) were considered to have navicular region p...
Harder J, Fürst AE, Montavon PM, Montavon S, Bakony M, Lanyi K.Calcium dobesilate has recently been used for treating lameness in horses because it enhances microvascular processes and reduces intraosseous pressure. Lameness caused by disorders in bone metabolism and increased intraosseous pressure, such as navicular disease, osseous cyst-like lesions and pedal bone oedema, are commonly treated with rest, anti-inflammatory agents and surgery. Calcium dobesilate has the potential to influence the pathophysiology of these diseases, thereby improving healing. To determine whether calcium dobesilate and its acting agent calcium 2,5-dihydroxybenzene sulfonate ...
Svalastoga E.Microangiographical investigations of the navicular bone in horses with navicular disease show, compared to similar investigations of normal navicular bones, that, in general, the vascular pattern is preserved but the vessels are dilated with "pooling" of the contrast medium subchondrally under facies flexoria. Similar changes may be observed in cases of human arthrosis. The present investigation therefore supports the view that navicular disease is a disease which resembles arthrosis.
Coffman JR, Johnson JH, Tritschler LG, Garner HE, Scrutchfield WL.Fourteen horses (7 treated with orgotein and 7 treated with a placebo) with navicular disease were studied on a double blind basis. All 14 horses had clinical and radiographic evidence of navicular disease. Orgotein and the placebo were administered by juxtabursal injection. Of the 7 orgotein-treated horses, 3 responded but none of the 7 placebo-treated horses responded. The difference was statistically significant (P less than 0.05).
Whitlock J, Dixon J, Sherlock C, Tucker R, Bolt DM, Weller R.Since the 1950s, veterinary practitioners have included two separate dorsoproximal-palmarodistal oblique (DPr-PaDiO) radiographs as part of a standard series of the equine foot. One image is obtained to visualise the distal phalanx and the other to visualise the navicular bone. However, rapid development of computed radiography and digital radiography and their post-processing capabilities could mean that this practice is no longer required. The aim of this study was to determine differences in perceived image quality between DPr-PaDiO radiographs that were acquired with a computerised radiogr...
Harcourt M, Smith C, Bell R, Young A.We describe the radiographic and magnetic resonance imaging findings associated with a case of bilateral forelimb bipartite navicular disease in a 7-year-old Warmblood gelding used for eventing. In addition to the radiographically evident partitioned navicular bones, magnetic resonance imaging (MRI) also detected other concurrent abnormalities occurring within the foot that have not been described before in other cases of navicular bone partition. MRI not only revealed soft tissue lesions of the podotrochlear apparatus, but also allowed for more detailed characterisation of the recently diagno...
Valdez H, Adams OR, Peyton LC.Of 124 horses determined to have navicular disease during a 5-year period, 6 had clinical and radiographic signs of the disease in both hindlimbs. These 6 were all castrated males, ranging in age from 3 to 12 years, and were used for work of similar nature: roping, cutting, and pleasure. Treatment consisted of posterior digital neurectomy and corrective shoeing in 2 cases, posterior digital neurectomy alone in 2 cases, and corrective shoeing alone in 2 cases. Following treatment, lameness subsided, and all 6 horses were returned to full use.