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.
Rose RJ, Allen JR, Hodgson DR, Kohnke JR.A peripheral vasodilating agent, isoxsuprine hydrochloride, administered as an oral paste, was evaluated to determine its efficacy for the treatment of navicular disease. In a clinical trial, 13 horses with navicular disease were treated at a dose rate of 0.6 mg/kg body weight (bwt) twice daily for periods of six to 14 weeks. Twelve of the horses became completely sound while being treated, although two required a 50 per cent increase in dose. Nine of the horses have remained sound two to 10 months after ceasing therapy. In a controlled randomised double blind clinical trial, 16 horses with na...
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.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.
Svalastoga E, Nielsen K.The histopathological changes in the synovial membrane of bursa podotrochlearis are described in horses with navicular disease. The changes are compared to the histopathological findings in synovial membrane of arthrotic pastern joints in horses and of arthrotic hips in man. A high degree of concordance is demonstrated and this suggests that navicular disease is an arthrotic disease.
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...
Fricker C, Riek W, Hugelshofer J.The digital arteries of 10 horses suffering from navicular disease, and 7 horses from a control group, were examined angiographically. The horses from the disease group showed complete or partial occlusion of the digital arteries in all cases. In the control group of 7 healthy horses, isolated vessel obstructions were also found but these were limited to narrowing of part of an artery only. Histological investigations showed that total occlusion of a vessel involved an organised thrombus but that partial occlusion generally involved changes to the vascular wall, similar to those caused by enda...
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...
Rose RJ.Three of the standard radiographic views of the navicular bone were assessed in normal horses and horses with navicular disease to determine the most effective radiographic positioning. Using the upright pedal view, a pastern angulation of 20 degrees from the vertical produced the optimum result when radiographs were taken using a grid. The best result using the high coronary view was obtained with an anode-film distance of 1 1000 mm, and a tube-head angle of 50 degrees from the vertical. When the special navicular view described by Morgan was examined, the most satisfactory projection was obt...
Arnbjerg J.After a short review of previous literature about fractures of the navicular bone in horses, the symptoms and the pathological-anatomical changes of the condition are described. The most important clinical symptom is acute severe lameness without significant swellings, but with pronounced pain reaction to rotation of the coffin joint. After rest the lameness is reduced considerably, but without treatment it can persist for several years. Adherences between the deep flexor tendon and the site of the fracture and eventual damage to the coffin joint are considered to be the cause of the persistin...
Colles CM.In a survey of 95 control horses and 16 horses with navicular disease, the incidence of erosions and discoloration of the flexor cartilage of the navicular bone was no different between the control horses and those with navicular disease. All cases of navicular disease showed thrombosis of the distal navicular nutrient arteries and this could be related to a change to a rounded or flask shape of the distal nutrient foramen of the navicular bone. Erosions and discoloration of the navicular bone are therefore of no significance in navicular disease. Previously described lines of treatment are of...
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).
Dik KJ, Németh F, Merkens HW.The radiological and clinical interpretation of alterations of the navicular bone, the interaction of radiological and clinical symptoms in relation to the age of the animal, the influence of work-load on this interaction and the possibility of predicting navicular disease at an early stage are discussed. The discussion is based on experience in a study of 130 horses.
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.
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...
Ackerman N, Johnson JH, Dorn CR.In a retrospective study, 74 horses met defined historical and clinical features indicative of navicular disease. Most of the affected horses were 4 to 9 years old. Males had a greater risk of navicular disease than females, geldings had a greater risk than stallions, and Quarter Horses had a greater risk than other breeds. Diagnostic radiographic changes were found in 42 of 70 horses examined. The distribution of diagnostic radiographic changes between the right and left fron feet was equal. There was no correlation between the finding of diagnostic radiographic changes and the horse's respon...
Németh F.The aetiology and pathogenesis of navicular bone disease and sesamoidosis are discussed on the basis of findings reported in the literature and research. A marked similarity is found to be present between the clinical presentation, aetiology and pathogenesis of these two diseases. In addition, the intra and juxta-articular signs of degeneration as seen in these diseases are similar to those seen in various forms of arthrosis. Circulatory disturbances resulting from partial or complete arterial occlusion, caused by arteriosclerosis, are likely to play an important role in the cause of degenerat...
Rubio-Martínez LM, Bracamonte JL, Tompkins S, Villarino NF.To describe a transthecal approach to the palmar pouch of the distal interphalangeal joint (DIPJ) in horses and compare it with the conventional blind arthroscopic technique. Methods: Ex vivo study. Methods: Cadaver forelimbs (n = 26 pairs) from mature horses. Methods: One limb from each pair was randomly assigned to each arthroscopic approach (conventional or transthecal). The conventional arthroscopic approach was performed as previously described and the transthecal approach was performed through sharp dissection of the distal reflection of the digital flexor tendon sheath (DFTS). The propo...
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...
Suarez-Fuentes DG, Caston SS, Tatarniuk DM, Kersh KD, Ferrero NR.Contaminated or septic navicular bursitis has been reported to have a guarded prognosis after surgical treatment with navicular bursotomy only. In our experience, the use of navicular bursotomy for the treatment of this disease in combination with systemic and local delivery of antimicrobials can provide a good prognosis, even in horses with chronic disease. Objective: To report the outcome of horses undergoing navicular bursotomy for the treatment of contaminated or septic navicular bursitis. Methods: Descriptive case series. Methods: Navicular bursotomy was performed in combination with syst...
Bowker RM, Rockershouser SJ, Vex KB, Sonea IM, Caron JP, Kotyk R.To determine whether the distal interphalangeal (DIP) joint directly or indirectly communicates with the navicular bursa (bursa podotrochlearis) and to identify sensory nerves in these synovial structures that might be desensitized by intra-articular injections of anesthetics, Evans blue dye in physiologic saline solution, Luxol fast blue dye with mepivicaine, or commercial latex was injected into the DIP joint (5 ml) or the navicular bursa (3 ml) of 152 digits obtained from horses or ponies at necropsy. The digits were frozen, cut with a band saw, and examined for distribution of dye or latex...
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...
Kofler J, Kneissl S, Malleczek D.Clinical, magnetic resonance imaging (MRI) and computed tomography (CT) findings of acute desmopathy of the lateral collateral sesmoidean (navicular) ligament (CSL) in a 13-year-old Hanoverian mare are presented. On admission to the clinic the horse showed a grade 5/6 left front-limb lameness at the walk, pain on coffin joint manipulation, and coffin joint effusion. Despite a positive palmar digital nerve block, radiographs and ultrasonography did not indicate reasons for the severe clinical signs. However, MRI revealed damage to the CSL and bone marrow oedema of the navicular bone (NB), where...
Gerlach K, Mader D, Delling U, Theuß T, Müller K, Offhaus J, Berner D.The aim of the present study was to verify the diagnostic validity of low-field magnetic-resonance-imaging (MRI) findings in septic diseases of the foot region following penetrating sole injuries caused by nails. Methods: MRI examinations were performed in 10 horses with injuries in the foot region. The diagnostic findings were validated by conventional methods (clinical, surgical, radiological, sonographic, and computed tomographic findings and/or post-mortem histological examination). Results: Navicular bone involvement was revealed most accurately, with a high degree of predictability, and ...
Drommer W, Damsch S, Winkelmeyer S, Hertsch B, Kaup FJ.In 25 adult horses the podotrochlea of 49 forelimbs was examined by means of light and electron microscopy in order to correlate clinical and morphological findings. According to the clinical diagnosis the animals were divided into three groups: lameness due to syndrome of podotrochlosis (group 1) or due to tendopathy (group 2) and horses without lameness (group 3). The most striking pathological findings of the navicular bone and the opposite surface of the deep flexor tendon were found in horses with podotrochlosis, consisting of loss of cartilage and tendon matrix with denudation of collage...
Meier HP.The genetic predisposition to navicular disease is proven nowadays, but otherwise, etiology and pathogenesis are still unclear. Causal therapy isn't possible and because of the poor prognosis, neurectomy is still of bearing. This operation was performed already 200 years ago, but in the middle of the last century, critical voices have been raised in regard to the surgical procedure and its indication both for medical reasons and breeding. Clear instructions for exclusion of diseased animals from breeding are also older than one hundred years. These facts call for ethic considerations which con...
Keller H, Grundmann S.X-rays of 205 horses having navicular disease and having been reexamined up to six times are evaluated. For this, the x-rays of each foreleg are evaluated in the dorsopalmar (Oxspring) and lateromedial view. Additionally to changes of the navicular bone, changes of the distal part of the toe are also assessed. Differences can be found in the radiographic process in view of the limitation of vascular foramina and cyst-like lesions. Vascular foramina with sclerotic rim grow less frequent than poorly defined ones and therefore allow for easier prognostication. Cyst-like lesions with sclerotic rim...
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...
Kane-Smyth J, Taylor SE, García EC, Reardon RJ.To evaluate the frequency of inadvertent penetration of the digital flexor tendon sheath (DFTS) and/or distal interphalangeal joint (DIPJ) when using a direct endoscopic approach to the navicular bursa, and to evaluate an alternate direct approach to the navicular bursa. Methods: Cadaveric study. Methods: Equine cadaver limbs (n = 40 for direct; n = 12 for alternate approach). Methods: Four surgeons performed the direct endoscopic approach to the navicular bursa on 10 limbs each. Frequencies of inadvertent synovial penetration and iatrogenic damage were compared between surgeons. Use of an alt...
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...
Honnas CM, Crabill MR, Mackie JT, Yarbrough TB, Schumacher J.Six horses with septic navicular bursitis or distal sesamoid osteomyelitis were treated by means of surgical debridement and lavage, followed by packing of the wound created in the bottom of the foot with an autogenous cancellous bone graft. Two horses were euthanatized, one 18 months after surgery because of complications in the contralateral support limb, and one 68 days after surgery because of continuing severe lameness. Four horses were alive 9, 16, 21, and 42 months after surgery. One horse was used as a broodmare and did not have observable lameness. Two horses were being ridden. The re...
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...
Rose RJ.Three of the standard radiographic views of the navicular bone were assessed in normal horses and horses with navicular disease to determine the most effective radiographic positioning. Using the upright pedal view, a pastern angulation of 20 degrees from the vertical produced the optimum result when radiographs were taken using a grid. The best result using the high coronary view was obtained with an anode-film distance of 1 1000 mm, and a tube-head angle of 50 degrees from the vertical. When the special navicular view described by Morgan was examined, the most satisfactory projection was obt...
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...
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...
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...
Trout DR, Hornof WJ, O'Brien TR.Radiography and soft tissue- and bone-phase scintigraphy were performed on 14 clinically normal horses and 35 horses in which definite, probable, or possible navicular disease had been diagnosed. The specificity of radiography and scintigraphy in revealing signs of navicular disease were nearly equal; however, the sensitivity of scintigraphy appeared to be greater than that of radiography. The greatest sensitivity and specificity were achieved when the results of radiography and scintigraphy were evaluated together. Differences in sensitivity were greatest when scintigraphy revealed lesions no...
Dik KJ, Németh F, Merkens HW.The radiological and clinical interpretation of alterations of the navicular bone, the interaction of radiological and clinical symptoms in relation to the age of the animal, the influence of work-load on this interaction and the possibility of predicting navicular disease at an early stage are discussed. The discussion is based on experience in a study of 130 horses.
McClure SR, Hooper RN, Watkins JP.A 13-month-old Quarter Horse colt sustained a puncture wound to the frog region of the foot, which penetrated the navicular bursa and distal interphalangeal joint, 7 days prior to examination. A street-nail procedure was performed to debride the tract and provide drainage of the navicular bursa and distal interphalangeal joint. An indwelling lavage system was placed through the dorsal aspect of the joint and antimicrobials were infused intermittently to supply a high local concentration of drug and to frequently lavage the distal interphalangeal joint and navicular bursa.
Hanson RR, Brawner WR, Blaik MA, Hammad TA, Kincaid SA, Pugh DG.Fourteen horses with a progressive forelimb lameness of 3 to 12 months' duration, diagnosed as navicular syndrome, were selected from clinical cases admitted to Auburn University Equine Hospital for evaluation of the efficacy of an orally administered nutraceutical (Cosequin, Nutramax Laboratories, Inc., Edgewood, MD) for ameliorating clinical signs associated with naturally occurring navicular syndrome. Horses were randomly allocated to treatment with the nutraceutical or a placebo. Treatment was five scoops (16.5 g) of powder twice daily in the feed. The test group (n = 8) received a patente...
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...
Rowan C, Puggioni A, Hoey SE, O'Leary JM, Kearney C, Connolly SE, Skelly C.The requirement to pack the sulcus of the equine foot as an aid to diagnostic interpretation before acquisition of dorsoproximal-palmarodistal oblique projections is debatable. The purpose of this study was to investigate the benefit of packing the sulcus in the assessment of normal anatomy. 23 cadaver limbs were radiographed in a podoblock (https://www.podoblock.com/products-page/podoblock/podoblock/) A non-packed image (NP) and a packed image (P) of the same foot were acquired. The image quality of P was graded against the reference NP by five observers, where -1=P was superior, 0=no differe...
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...
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 ...
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...
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 ...
