Evaluation of foot pain in the standing horse by magnetic resonance imaging.
Authors: Sherlock C E, Kinns J, Mair T S
Journal: The Veterinary record
Summary
# Editorial Summary: Standing MRI in Equine Foot Lameness This retrospective review examined 41 horses with persistent foot pain of unclear origin using standing MRI, with owners providing follow-up data at two years post-examination. The imaging revealed that multiple soft tissue and osseous pathologies commonly coexist within the foot, though the clinical significance of these findings varies considerably—deep digital flexor tendonitis (identified in 12 horses) and distal interphalangeal joint distension (15 horses) did not always correlate with lameness, whereas navicular bursal distension proved highly significant, presenting in seven horses and consistently producing clinical lameness in all cases. Long-term outcomes for 27 surviving horses showed that 16 returned to previous performance levels, but those with navicular bursal involvement had the poorest prognosis: four of five were euthanased due to uncontrolled lameness, with only one returning to reduced work. These findings highlight that standing MRI can identify pathology undetectable on radiographs—particularly navicular bone lesions (13 horses)—and emphasises that diagnostic imaging findings require clinical correlation; practitioners should recognise that navicular bursal disease represents a particularly challenging and often career-ending condition, whilst other common foot lesions may be compatible with sound athletic function if appropriately managed.
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Practical Takeaways
- •Standing MRI reveals soft tissue pathology in lame horses that radiography misses, particularly navicular bone lesions—consider MRI when radiographs are inconclusive.
- •Navicular bursal distension carries a guarded prognosis and should be treated aggressively, as it consistently causes lameness and is often refractory to management.
- •Not all MRI findings correlate with lameness—deep digital flexor tendonitis and DIP joint changes may be incidental, so clinical interpretation alongside imaging findings is essential.
Key Findings
- •Deep digital flexor tendonitis was identified in 12 of 41 horses (29%), and distal interphalangeal joint distension in 15 (37%), but neither was always associated with lameness.
- •Navicular bursal distension was present in 7 horses (17%) and was invariably associated with lameness in all affected cases.
- •Navicular bone lesions were identified in 13 horses (32%), often without radiographic changes, highlighting the superior diagnostic capability of MRI.
- •Two-year follow-up of 27 surviving horses showed 16 (59%) returned to previous performance level, but 4 of 5 horses with navicular bursal changes required euthanasia due to lameness.