Outcomes of podotrochlear (navicular) bursa injections for signs of foot pain in horses evaluated via magnetic resonance imaging: 23 cases (2005-2007).
Authors: Bell, Howard, Taylor, Voss, Werpy
Journal: Journal of the American Veterinary Medical Association
Summary
# Editorial Summary: Navicular Bursa Injections for Equine Foot Lameness MRI evaluation of 23 horses with foot pain undergoing podotrochlear bursa injection revealed that diagnostic imaging findings were strongly predictive of treatment success, with 74% achieving excellent outcomes and returning to work within 2–4 weeks. Horses with isolated navicular bursitis responded optimally to corticosteroid injection, whilst those with erosive lesions of the distal sesamoid bone's flexor surface (seven of eight cases) experienced poor outcomes regardless of treatment protocol. Corticosteroid dose proved significant—animals receiving less than 10 mg of triamcinolone had substantially worse results than those receiving higher doses, whereas concurrent hyaluronate administration did not influence outcome. Among successful cases, mean soundness duration extended to 7.3 months. For practitioners employing diagnostic imaging to differentiate navicular pathology, these findings underscore the importance of MRI diagnosis prior to bursa injection: horses with bursitis alone represent ideal candidates for this intervention, whilst those with erosive bone lesions and deep digital flexor tendon adhesions warrant consideration of alternative or complementary therapeutic approaches.
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Practical Takeaways
- •Navicular bursa injections are effective for lameness when primary pathology is bursitis alone; use adequate corticosteroid doses (≥10 mg triamcinolone) for optimal results
- •MRI screening is valuable—horses with erosions on the flexor surface of the navicular bone coupled with DDFT adhesions should be counselled that injection response will likely be poor
- •Expect 7–8 months of usable soundness in successful cases, allowing time to implement complementary therapeutic strategies before lameness recurs
Key Findings
- •74% (17/23) of horses achieved excellent outcomes and returned to intended use within 2–4 weeks following navicular bursa injection
- •Horses receiving <10 mg of triamcinolone had significantly worse outcomes than those receiving higher doses, regardless of hyaluronate co-administration
- •Mean soundness duration after successful treatment was 7.3 months
- •87.5% (7/8) of horses with erosive lesions of the flexor surface of the navicular bone had poor outcomes following injection