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A. Equine and Camelid Medicine and Surgery > Equine Musculoskeletal: Navicular Syndrome > Flashcards

Equine Musculoskeletal: Navicular Syndrome Flashcards

1
Q

how common is navicular syndrome?

A

most common degenerative disorder of the foot causing lameness

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2
Q

what makes up the podotrochlear apparatus?

A

navicular bone
collateral sesamoidean ligaments
impar ligament
deep digital flexor tendon
navicular bursa
coffin joint- partially

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3
Q

which horses are genetically predisposed to navicular syndrome?

A

quarter horses
thoroughbreds
warmbloods

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4
Q

what does increased stiffness of bone lead to?

A

overload of cartilage

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5
Q

what is history like with navicular syndrome?

A

mostly chronic front limb lameness, often intermittent
lameness can also be acute onset
most often bilateral front, can be unilateral

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6
Q

which radiograph views are used for the navicular bone?

A

lateral view
60 degree dorso-palmar view
proximopalmar-to-distopalmar tangential view- “skyline”

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7
Q

what changes can be seen with the proximopalmar-to-distopalmar tangtial view- “skyline”?

A

medullary sclerosis
loss of corticomedullary junction- flexor surface
irregularities along the flexor surface
may be normal

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8
Q

what does a nuclear scintigraphy bone scan show?

A

bony inflammation

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9
Q

what are some abnormal findings in an MRI for navicular syndrome?

A

navicular bone edema
deep digital flexor tendonitis
desmitis
navicular bursitis
adhesions within navicular bursa

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10
Q

how can navicular syndrome be medically managed mainly?

A

corrective shoeing
NSAIDs
intra-articular therapy
intra-bursal therapy
biphosphonates

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11
Q

when are biphosphonates used?

A

primarily in cases of primary navicular bone degeneration

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12
Q

what is the mode of action of biphosphonates?

A

biphosphonate is taken up by osteoclasts inducing inactivation or apoptosis

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13
Q

what are the surgical options for navicular syndrome?

A

navicular buroscopy
palmar digital neurectomy

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14
Q

when can palmar/plantar digital neurectomy be performed?

A

when medical treatment or buroscopy is unsuccessful
first option: in cases with navicular bone changes

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15
Q

where is the incision made for palmar/plantar digital neurectomy?

A

over ligament of ergot

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16
Q

what is navicular syndrome?

A

injury to one or several components of the equine podotrochlear apparatus

17
Q

what is the podotrochlear apparatus?

A

palmar/plantar structures of the foot around the navicular bone as fulcrum

18
Q

is navicular syndrome unilateral or bilateral?

A

bilateral

19
Q

what conformation predisposes a horse to navicular syndrome?

A

narrow upright feet
straight or upright pastern
large body with small hoof size

20
Q

what does increased stiffness of bone lead to?

A

overload to cartilage

21
Q

what does upregulation of blood supply to navicular bone promote?

A

neovascularizatin

22
Q

what do new blood vessels in the medulla of bone leaking serum into the perivascular space lead to?

A

perivascular fibrosis
bone edema
obstruction of venules
intra-osseous pressure increase
bone pain

23
Q

what nerve block can help with identifying navicular syndrome?

A

palmar digital nerve anesthesia

24
Q

what changes can be seen with the 60 degree dorso-palmar view with navicular syndrome?

A

irregularities along the distal border
marginal osteophytes/enthesiophytes
cyst-like lesions
medullary sclerosis

25
Q

what structures can be seen with ultrasound in looking for navicular syndrome?

A

deep digital flexor tendon
navicular bursa
parts of coffin joint
collateral ligament of the navicular bone
impar ligament
bony line of navicular bone

26
Q

where does radioisotope concentrate in nuclear scintigraphy?

A

areas of increased bony activity

27
Q

what are the main abnormal findings in MRI for navicular syndrome?

A

navicular bone edema
deep digital flexor tendonitis
desmitis
navicular bursitis
adhesions within navicular bursa

28
Q

what is done in corrective shoeing for navicular syndrome?

A

egg bar shoe with 2-3 degree wedge
shorten toes and shoe with squared toe
use shoe slightly wider than foot

29
Q

when are biphosphonates used?

A

primarily in cases of primary navicular bone degeneration

30
Q

when might a navicular bursoscopy be performed?

A

adhesions
DDFT tears
damage to flexor surface of navicular bone

31
Q

when is a palmar/plantar digital neurectomy the first choice?

A

navicular bone changes

32
Q

what is the most common reason a palmar/plantar digital neurectomy fails?

A

regeneration of the transected nerve

A. Equine and Camelid Medicine and Surgery (56 decks)

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