"Contrast Medium Controlled Injection in the Navicular Bursa and the Following Bursography in 23 Cases"
Authors: Christian Staufenbiel
Journal: Biomedical Journal of Scientific & Technical Research
Summary
Navicular disease remains a leading cause of chronic front-limb lameness in horses, yet many practitioners lack access to advanced imaging such as MRI, and ultrasound can prove technically challenging in the palmar foot. Staufenbiel's work evaluated contrast-enhanced radiography using the dorsoproximal-palmarodistal oblique (DPr-PaDiO) projection as an alternative diagnostic approach, documenting 23 attempted injections into the navicular bursa with subsequent imaging to assess bursal integrity and soft tissue involvement. Twenty injections successfully filled the navicular bursa; notably, contrast medium escaped into the palmar soft tissues alongside the deep digital flexor tendon in five cases (25%), suggesting bursal compromise, whilst contrast entered the distal interphalangeal joint in only one case, indicating generally good needle placement. Among the nine cases with lameness history, abnormal contrast patterns were identified in 77.8%, revealing findings including deep digital flexor tendon lesions, full cortex involvement, suspected navicular bursa ruptures, and adhesions. For practitioners managing navicular cases without MRI access, contrast-enhanced radiography offers a practical, cost-effective supplementary diagnostic tool that can clarify bursal pathology and guide treatment decisions, particularly regarding suitability for intrabursal medication.
Read the full abstract on the publisher's site
Practical Takeaways
- •When MRI is unavailable or ultrasound is impossible, contrast-enhanced DPr-PaDiO radiography offers a practical and affordable alternative to diagnose navicular bursa pathology and guide intrabursal treatment decisions
- •Successful bursal injection combined with contrast radiography can reveal concurrent DDFT lesions and bursal ruptures that may not be apparent on conventional imaging, improving diagnostic accuracy
- •The 25% rate of contrast leakage beyond the bursa suggests careful injection technique and post-injection monitoring are necessary to ensure medication reaches the intended structure
Key Findings
- •20 of 23 contrast-enhanced DPr-PaDiO radiographic injections into the navicular bursa were successful, demonstrating feasibility of the technique
- •Contrast medium palmar to the deep digital flexor tendon occurred in 5/20 (25%) successful injections, suggesting bursal compromise
- •Contrast-enhanced radiography identified pathology in 7/9 (77.78%) cases with clinical lameness history, including 2 DDFT lesions, 3 suspected bursal ruptures, and 5 adhesions
- •This imaging technique is inexpensive and widely available compared to MRI, providing an accessible diagnostic option for suspected navicular disease