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.
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...
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...
Ruohoniemi M, Ryhänen V, Tulamo RM.Radiographic findings in the navicular bone and distal interphalangeal joint as well as the ossification status of the collateral cartilages of the distal phalanx were evaluated in 100 Finnhorse cadaver forefeet. The most common shapes of the proximal articular margin of the navicular bone were convex and straight. Remodeling of the navicular bone was common, especially on the lateral extremity. No bony fragments were identified at the distal flexor margin even though this area appeared irregular in several feet. Several large, rounded or lollipop-shaped synovial invaginations were identified ...
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...
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...
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...
Honnas CM, Schumacher J, Kuesis BS.A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an att...
van Dixhoorn ID, Meershoek LS, Huiskes R, Schamhardt HC.Motion of the navicular bone might play a role in the development of navicular disease in horses but is difficult to asses. In the present study, 3-dimensional motion of this bone was determined using roentgen stereophotogrammetric analysis. Tantalum pellets were inserted, in vitro, in the bones of 6 forelimbs of mature Shetland ponies and kinematics were measured during vertical loading up to 2 kN. The motions of the navicular bone and coffin joint were limited to flexion/extension, there were no substantial out-of-plane motions. There was only little flexion between the navicular bone and th...
Dik KJ, van den Belt AJ, van den Broek J.Estimating the shape of the proximal articular border of the navicular bone and grading the radiological navicular bone condition (grades 3 and 4 representing the most severe changes), the aim of this study was to assess potential age-related implications of the previously reported shape predisposition to navicular disease in 746 normal and 174 clinically affected Dutch Warmbloods age 3-19 years. A significant, age-independent, shape-grade association found in normal and affected horses emphasises the fundamental character of the shape predisposition to navicular disease. A significant age-rel...
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.
Pleasant RS, Baker GJ, Foreman JH, Eurell JA, Losonsky JM.Navicular bone intraosseous pressure, gross pathologic, histologic, and histochemical data were collected from 8 horses with navicular disease and 4 control horses. Simultaneous navicular bone intraosseous, medial palmar arterial, and saphenous venous pressures were measured for the left and right forelimbs of each horse under general anesthesia. Gross pathologic evaluation included grading of changes on the flexor surface of the navicular bone. Safranin-O-fast green-stained sections were used for histologic-histochemical grading of the hyaline articular and fibrocartilage surfaces of the navi...
Dyson S, Murray R.Nuclear scintigraphy is commonly used as a diagnostic aid for foot pain, but there is limited information about different patterns of radiopharmaceutical uptake (RU) and their correlation with the results of other imaging modalities. Objective: To describe patterns of RU in horses with foot pain. Methods: Scintigraphic images of the feet of 264 horses with front foot pain were analysed subjectively and using region of interest analysis. Magnetic resonance images of all feet were analysed prospectively; the navicular bones were reassessed retrospectively and assigned a grade. A Spearman rank co...
Spriet M, Espinosa P, Kyme AZ, Phillips KL, Katzman SA, Galuppo LD, Stepanov P, Beylin D.Positron emission tomography (PET) is a cross-sectional, functional imaging modality that has recently become available to the horse. The use of 18 F-sodium fluoride (18 F-NaF), a PET bone tracer, has not previously been reported in this species. Objective: To assess the feasibility of 18 F-NaF PET in the equine distal limb and explore possible applications in the horse in comparison with other imaging modalities. Methods: Exploratory descriptive study involving three research horses. Methods: Horses were placed under general anaesthesia prior to intravenous (i.v.) administration of 1.5 MBq/kg...
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.
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...
Boyce M, Malone ED, Anderson LB, Park S, Godden SM, Jenner F, Trumble TN.To determine whether triamcinolone acetonide diffuses from the distal interphalangeal joint (DIPJ) to the navicular bursa, diffusion is direct or systemic, and addition of sodium hyaluronan has an effect on diffusion in horses. Methods: 11 adult horses without forelimb lameness. Methods: 1 randomly chosen forelimb DIPJ of each horse received an injection of 10 mg of triamcinolone acetonide plus 20 mg of sodium hyaluronan (group 1), and the contralateral forelimb DIPJ received an injection of 10 mg of triamcinolone acetonide plus 2 mL of lactated Ringer's solution (group 2). Synovial fluid samp...
van der Zaag EJ, Weerts EA, van den Belt AJ, Back W.Navicular bone partition is a rare condition reported in horses, which is during the evaluation of a lameness or prepurchase examination often misinterpreted for a parasagittal fracture. In this report, the clinicopathological findings of three cases of navicular bone partition are evaluated. The possible pathomechanisms underlying the condition are hypothesised, focusing on a potential origin of foetal vascular disturbance. This study is furthermore aiming at a clearer and earlier recognition of navicular bone partition, since this condition would finally predispose for a clinical lameness wi...
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...
Grewal JS, McClure SR, Booth LC, Evans RB, Caston SS.To characterize the normal ultrasonographic appearance of the podotrochlear apparatus in horses by use of standardized measurements and identify soft tissue changes associated with navicular syndrome. Methods: Prospective study. Methods: 7 clinically normal horses and 28 horses with navicular syndrome. Methods: The feasibility of identifying and measuring the soft tissue structures of the podotrochlear apparatus ultrasonographically via the transcuneal approach was assessed in 2 additional horses without navicular syndrome; both horses were euthanatized, and the structures identified ultrasono...
Viitanen M, Bird J, Smith R, Tulamo RM, May SA.The study hypothesis was that navicular disease is a process analogous to degenerative joint disease, which leads to changes in navicular fibrocartilage and in deep digital flexor tendon (DDFT) matrix composition and that the process extends to the adjacent distal interphalangeal joint. The objectives were to compare the biochemical composition of the navicular articular and palmar cartilages from 18 horses with navicular disease with 49 horses with no history of front limb lameness, and to compare navicular fibrocartilage with medial meniscus of the stifle and collateral cartilage of the hoof...
Dyson S, Murray R.Use of physiological methods of diagnostic imaging could provide insight into the pathogenesis of foot pain in live horses. Objective: To describe patterns and intensity of increased radiopharmaceutical uptake (IRU) in the navicular bone, and relate this to distribution and types of signal intensity change in the navicular bone and to the presence or absence of lesions of the related soft tissue structures detected using MRI. Methods: Scintigraphic and MR images of 264 horses with unilateral or bilateral foot pain were analysed and graded. A Spearman rank correlation was used to test for relat...
Williams GE.To determine whether force-plate evaluation of horses with navicular disease would reveal an abnormal gait that persists despite loss of sensation to the palmar foot region, which may predispose such horses to navicular disease. Methods: 17 clinically normal Thoroughbreds and 8 Thoroughbreds with navicular disease. Methods: Data on ground reaction forces were obtained in trotting horses, using a force plate. Force-time curve variables for clinically normal horses were derived from 4 points at the beginning and 4 points at the end of the vertical and craniocaudal horizontal plots. Principal com...
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 ...
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 ...
