The arterial supply of the navicular bone in adult horses with navicular disease.
Authors: Rijkenhuizen, Németh, Dik, Goedegebuure
Journal: Equine veterinary journal
Summary
# Editorial Summary: Arterial Supply and Navicular Disease Rijkenhuizen and colleagues investigated the vascular architecture of navicular bones in 40 Warmblood horses with clinical and/or radiographic navicular disease, employing macroscopic examination, arteriography and histological analysis to map how blood supply patterns change with disease progression. Their arteriographic findings revealed a pronounced shift in arterial distribution: the distal blood supply becomes compromised whilst the proximal, medial and lateral vessels enlarge compensatorily, suggesting the diseased bone attempts to maintain perfusion through alternative routes. Histologically, this vascular remodelling manifests as arteriolosclerosis and neovascularisation, with radiologically visible nutrient foramina correlating with increased bone remodelling and fibrosis. The authors propose that local ischaemia combined with elevated intra-articular pressure drives these pathological changes in vessel calibre and nutrient foramen prominence. For practitioners, these findings underscore that navicular disease involves progressive vascular insufficiency rather than simple mechanical failure; this mechanistic understanding may inform therapeutic strategies targeting tissue perfusion, pressure reduction and early intervention before irreversible fibrosis develops.
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Practical Takeaways
- •Navicular disease involves progressive vascular compromise with a shift from distal to proximal blood supply; understanding this hemodynamic change helps explain disease progression and supports early intervention strategies
- •The presence and pattern of nutrient foramina on radiographs may serve as indicators of vascular insufficiency and bone remodelling severity, potentially helping stratify disease cases
- •Management approaches targeting vascular health, pressure reduction, and perfusion (e.g., palliative therapies, shoeing modifications to reduce intra-articular pressure) align with the underlying pathophysiology of blood supply disruption
Key Findings
- •Navicular disease in horses shows arteriographic changes with distal-to-proximal shift in arterial supply pattern, indicating reduced distal blood flow with compensatory proximal vessel reaction
- •Histological examination revealed arterio(lo)sclerosis and newly formed arteries corresponding to arteriographic pattern changes
- •Radiologically visible nutrient foramina were associated with altered arteriogram patterns, increased bone remodelling, and fibrosis
- •Ischaemia and increased pressure (hypertension and/or increased intra-articular pressure) are implicated as causative factors in nutrient foramen changes