Pedal osteitis is a common radiographic diagnosis of lameness in horses feet but should be considered more of a description than a diagnosis. The term "pedal osteitis" translates to inflammation of the toe (coffin / P3) bone. Radiographically the coffin bone normally has irregular areas, most commonly along the margin and in the vascular channels. So, when you have a horse with lameness that blocks out at the foot and can find no likely cause: is that irregular coffin bone margin trying to tell you something or is it a red herring? Any inflammatory disease condition (infection, trauma, cancer, keratoma, etc.) could be labeled as a form of secondary pedal osteitis. Primary pedal osteitis is probably a result of chronic trauma. This article discusses the diagnosis and treatment of non-infectious pedal osteitis.

The term "pedal osteitis" (PO) is most likely the result of trauma and/or focal pressure at the solar margin of the coffin bone (P3). The inflammation set up by this trauma and causes both bone loss and reactive new bone production visible on radiographs. Once these bony changes have occurred, they are permanent. When seen on radiographs the determination has to be made whether this is an active problem causes lameness or just the remainder of an old problem that is no longer causing pain. Because of this it is important that radiographs not be used as a primary diagnostic tool for PO. Pedal osteitis is most often secondary to other disease conditions that includes laminitis, infection, fractures of P3, chronic solar bruising, flexural deformity of the DIP joint (clubfoot), keratomas, and puncture wounds. The front feet are more often effected most likely because of the increased concussive forces in these feet compared with the hindfeet. Demineralization can be severe and predisposes to solar margin fractures.