Outcomes of podotrochlear (navicular) bursa injections for signs of foot pain in horses evaluated via magnetic resonance imaging: 23 cases (2005-2007).
Abstract: To determine clinical outcome following intrathecal injection of the podotrochlear (navicular) bursa for signs of foot pain in horses evaluated via magnetic resonance imaging (MRI) and evaluate efficacy of corticosteroids administered with or without hyaluronate. Methods: Retrospective case series. Methods: 23 horses. Methods: Data collected included signalment, history, intended use, duration and severity of lameness, results of diagnostic anesthesia, radiographic abnormalities, MRI abnormalities, and outcomes for return to use. Results: MRI was conducted on 23 horses with lameness localized to the foot. Thirteen horses had bilateral forelimb lameness, and 10 had unilateral forelimb lameness. Mean duration of lameness was 10.5 months. Seventeen of 23 (74%) horses had excellent outcomes and returned to intended use within 2 to 4 weeks after navicular bursa injection. Hyaluronate treatment was not associated with outcome; however, horses receiving < 10 mg of trimacinolone had significantly worse outcomes than those treated with hyaluronate. Among horses with excellent outcomes, mean duration of soundness was 7.3 months. Seven of 8 horses with erosive lesions of the flexor surface of the distal sesamoid (navicular) bone diagnosed via MRI had a poor outcome. Horses with navicular bursitis responded optimally to injection, compared with horses with other problems. Conclusions: Results suggested that intrathecal injection of corticosteroid in horses with erosions of the flexor surface of the navicular bone associated with deep digital flexor tendon adhesions yielded a poor response. Treatment of horses with navicular bursitis via injection of the navicular bursa should be highly effective in alleviating lameness.
Publication Date: 2009-04-02 PubMed ID: 19335243DOI: 10.2460/javma.234.7.920Google Scholar: Lookup
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- Journal Article
- Case Reports
- Clinical Study
- Clinical Symptoms
- Corticosteroids
- Deep Digital Flexor Tendon
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Disease Treatment
- Equine Health
- Horses
- Intra-Articular Injection
- Lameness
- Magnetic Resonance Imaging
- Navicular Bone
- Pain Management
- Retrospective Study
- Veterinary Care
- Veterinary Medicine
- Veterinary Procedure
Summary
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The research investigated the outcomes of using intrathecal injections to treat horses suffering from foot pain, specifically in the podotrochlear or navicular bursa. The study concludes that this treatment method is effective for most horses, except those with certain MRI-diagnosed conditions, such as erosions on the flexor surface of the navicular bone.
Methodology
- The study followed a retrospective case series model and involved data gathered from 23 horses.
- Information compiled included the horses’ characteristics, their veterinary history, intended use, the duration and severity of their lameness, results of diagnostic anesthesia, radiographic abnormalities, MRI abnormalities, and the success in their return to use.
- The horses that had been experiencing lameness localized to the foot were subjected to an MRI examination. Some horses showed lameness on both forelimbs, others on only one.
Results
- Results show that after receiving a navicular bursa injection, about 74% of the horses studied had excellent outcomes and returned to their intended use between two to four weeks.
- This study found that the addition of hyaluronate to the injection did not significantly affect the outcome. However, horses that received less than 10mg of trimacinolone, a type of corticosteroid, experienced noticeably worse outcomes than those given a higher dose.
- Of the horses that showed excellent response to treatment, they remained sound for an average of about seven months.
- Only one out of the eight horses that were diagnosed with erosive lesions on the flexor surface of their navicular bone had a positive outcome.
- Horses that were diagnosed with navicular bursitis responded the best to the injection therapy.
Conclusions
- The results suggest that the use of intrathecal injection of corticosteroid did not fare well on horses diagnosed via MRI with erosions on the flexor surface of the navicular bone, especially if these erosions were associated with deep digital flexor tendon adhesions.
- On the other hand, if horses are diagnosed with navicular bursitis, having an injection to the navicular bursa could be an effective means to alleviate the lameness they experience.
Cite This Article
APA
Bell CD, Howard RD, Taylor DS, Voss ED, Werpy NM.
(2009).
Outcomes of podotrochlear (navicular) bursa injections for signs of foot pain in horses evaluated via magnetic resonance imaging: 23 cases (2005-2007).
J Am Vet Med Assoc, 234(7), 920-925.
https://doi.org/10.2460/javma.234.7.920 Publication
Researcher Affiliations
- Arizona Equine Medical and Surgical Center, 1685 S Gilbert Rd, Gilbert, AZ 85296, USA.
MeSH Terms
- Adrenal Cortex Hormones / therapeutic use
- Animals
- Bursa, Synovial
- Female
- Foot Diseases / diagnosis
- Foot Diseases / drug therapy
- Foot Diseases / veterinary
- Forelimb
- Hoof and Claw
- Horse Diseases / diagnosis
- Horse Diseases / drug therapy
- Horses
- Hyaluronic Acid / therapeutic use
- Injections, Intra-Articular / veterinary
- Lameness, Animal / diagnosis
- Lameness, Animal / drug therapy
- Magnetic Resonance Imaging / methods
- Magnetic Resonance Imaging / veterinary
- Male
- Pain / diagnosis
- Pain / drug therapy
- Pain / veterinary
- Retrospective Studies
- Severity of Illness Index
- Treatment Outcome
Citations
This article has been cited 5 times.- Barrett MF, Goorchenko GE, Frisbie DD. Comparison of Ultrasound and Magnetic Resonance Imaging for Identifying Soft Tissue Abnormalities in the Palmar Aspect of the Equine Digit. Animals (Basel) 2023 Jul 17;13(14).
- Quam VG, Altmann NN, Brokken MT, Durgam SS. Zonal characterization and differential trilineage potentials of equine intrasynovial deep digital flexor tendon-derived cells. BMC Vet Res 2021 Apr 1;17(1):138.
- Osborn ML, Cornille JL, Blas-Machado U, Uhl EW. The equine navicular apparatus as a premier enthesis organ: Functional implications. Vet Surg 2021 May;50(4):713-728.
- Scharf A, Acutt E, Bills K, Werpy N. Magnetic resonance imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions. Equine Vet J 2025 Sep;57(5):1183-1203.
- Larsen EA, Williams MR, Schoonover MJ, Jurek KA, Young JM, Duddy HR. Navicular bone fracture and severe deep digital flexor tendinopathy after palmar digital neurectomy in two horses. Open Vet J 2023 Dec;13(12):1752-1759.
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