A study of 118 cases of navicular disease: clinical features.
Authors: Wright
Journal: Equine veterinary journal
Summary
# Editorial Summary: Wright (1994) Wright's analysis of 118 horses with navicular disease (mean age 9.2 years) provides valuable insights into the clinical presentation and diagnostic indicators of this common degenerative condition, with lameness duration ranging from 1 to 72 months and 84.7% having received prior treatment. Bilateral involvement was evident in 78% of cases without laterality bias, whilst conformation defects were nearly universal, with 75% exhibiting broken foot–pastern axes and 45% showing mediolateral foot imbalance; these findings were frequently accompanied by significant muscle atrophy in 77% of horses, correlating with lameness severity. Diagnostic testing proved relatively insensitive, with only 11% responding positively to hoof testers and just 3% to percussion, yet flexion tests (positive in 64% of cases) and particularly turning towards the affected limb (positive in 95%) were highly reliable clinical indicators of navicular involvement. Local analgesia provided critical diagnostic confirmation, with 91% of tested horses responding to distal interphalangeal joint blocks and 92% to navicular bursa infiltration, substantially outperforming conventional hoof diagnostic tools. For practitioners managing these cases, this evidence underscores that clinical evaluation must integrate gait analysis, flexion responses and turning tests alongside rigorous local anaesthetic diagnostics, as traditional farrier assessment techniques lack sufficient sensitivity for reliable navicular diagnosis.
Read the full abstract on PubMed
Practical Takeaways
- •Expect bilateral navicular disease in most cases; unilateral presentation should not rule out contralateral involvement and warrants thorough evaluation of both feet
- •Assess foot conformation carefully as broken axes and mediolateral imbalance are present in majority of cases and may guide farriery interventions
- •Use distal interphalangeal joint and navicular bursa local anesthesia as reliable diagnostic confirmatory tests, as hoof testers and percussion have poor sensitivity (11% and 3% respectively)
Key Findings
- •78% of horses with navicular disease were bilaterally affected with no left-right limb predominance
- •75% of cases exhibited broken foot/pastern axes and 45% had mediolateral foot imbalance
- •Flexion of distal joints increased lameness severity in 64% of horses, while turning toward the lame limb exacerbated lameness in 95%
- •Local analgesia of the distal interphalangeal joint (91%) and navicular bursa (92%) were highly positive diagnostic indicators