20 Improved case selection on the basis of high-field MRI findings may improve the success of this treatment.Ī frequent abnormality observed in horses with chronic navicular syndrome is fibrous tissue in the proximal aspect of the navicular bursa creating adhesions between the DDF tendon and the CSL. 9–17,22,23 Outcome in a group of 23 horses treated by injection of the navicular bursa has been reported. Horses with pathological changes in and adjacent to the navicular bursa can be identified on MRI images from a high-field (≥ 1.0-T) magnet.
21 Magnetic resonance imaging has allowed more specific identification of causes of lameness localized to the foot in horses. Prior to MRI, case selection for injection of the navicular bursa was performed on the basis of clinical signs and failure to respond to treatment. 9–19 Treatment depends on the duration of the problem and the location of the pathological change. 9–19 Abnormalities in any of these structures have the potential to cause signs of pain, which is alleviated by injection of local anesthetic around the palmar digital nerves. Pathological changes in numerous structures within the foot, including the distal sesamoid (navicular) bone, distal sesamoidean impar ligament, CSL, navicular bursa, DDF tendon, collateral ligaments of the distal or proximal interphalangeal joint, distal digital annular ligament, distal phalanx, middle phalanx, or laminae, can cause clinical signs of navicular syndrome.
As a result, treatment can now be based on the localization of the pathological abnormalities within the foot. 9,10 Magnetic resonance imaging has become a valuable diagnostic tool that allows recognition of many abnormalities within horses with navicular syndrome. 2–8 Experience with MRI over the past 12 years has improved the detection of bone and soft tissue injuries within the feet of horses with navicular syndrome. 1 Diagnosis of navicular syndrome in the past has been made on the basis of clinical signs, response to diagnostic local anesthesia, radiographic findings, nuclear scintigraphy, and in some horses, ultrasonography and response to treatment. Navicular syndrome continues to be one of the most common causes of forelimb lameness in many types of athletic horses. Horses with scar tissue in the proximal portion of the navicular bursa, adhesions from the navicular bone to the DDF tendon, or multiple abnormalities did not respond as well to treatment.Ĭonclusions and Clinical Relevance-Response to navicular bursa injection with corticosteroid and hyaluronan in horses with navicular syndrome was dependent on the disease process detected on MRI and duration of lameness. Horses with primary deep digital flexor (DDF) tendonitis responded best to navicular bursa injection with rest and rehabilitation, followed by horses with navicular bursitis and horses with DDF tendonitis and adhesions to the collateral sesamoidean ligament of the distal sesamoid (navicular) bone.
Horses that had been lame for < 6 months before treatment were significantly more likely to return to their intended use, have a longer positive response to treatment, and be sound at follow-up, compared with horses that had a longer lameness history. Results-Following navicular bursa injection, 76 of 101 (75%) horses returned to their intended use for a mean of 9.66 months, and 35 (35%) were sound at follow-up. Follow-up information was obtained a minimum of 10 months after navicular bursa injection. Data on signalment, use of the horse, history, affected limbs, duration of lameness, findings on lameness examination, radiographic findings, MRI findings, treatment, and outcome were collected from the medical records. Procedures-Medical records of horses with signs of navicular syndrome evaluated between January 2000 and December 2008 were reviewed. Objective-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.Īnimals-101 horses with navicular syndrome.
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