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  Discussion on Research Study: MRI diagnosis of navicular bone erosions
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DrO

Posted on Tuesday, Feb 17, 2009 - 8:23 am:

Erosions of the flexor aspect of the navicular bone is a difficult diagnosis with exam and radiography alone, particularly early in the course of the disease. Though standing MRI usually does not result in images as godd as with general anesthesia, it was useful in the diagnosis of such lesions in this study.
DrO


Equine Vet J. 2008 Nov;40(7):684-92.
Deep erosions of the palmar aspect of the navicular bone diagnosed by standing magnetic resonance imaging.

Sherlock C, Mair T, Blunden T.

Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent ME18 5GS, UK.

REASONS FOR PERFORMING STUDY: Erosion of the palmar (flexor) aspect of the navicular bone is difficult to diagnose with conventional imaging techniques. OBJECTIVES: To review the clinical, magnetic resonance (MR) and pathological features of deep erosions of the palmar aspect of the navicular bone. METHODS: Cases of deep erosions of the palmar aspect of the navicular bone, diagnosed by standing low field MR imaging, were selected. Clinical details, results of diagnostic procedures, MR features and pathological findings were reviewed. RESULTS: Deep erosions of the palmar aspect of the navicular bone were diagnosed in 16 mature horses, 6 of which were bilaterally lame. Sudden onset of lameness was recorded in 63%. Radiography prior to MR imaging showed equivocal changes in 7 horses. The MR features consisted of focal areas of intermediate or high signal intensity on T1-, T2*- and T2-weighted images and STIR images affecting the dorsal aspect of the deep digital flexor tendon, the fibrocartilage of the palmar aspect, subchondral compact bone and medulla of the navicular bone. On follow-up, 7/16 horses (44%) had been subjected to euthanasia and only one was being worked at its previous level. Erosions of the palmar aspect of the navicular bone were confirmed post mortem in 2 horses. Histologically, the lesions were characterised by localised degeneration of fibrocartilage with underlying focal osteonecrosis and fibroplasia. The adjacent deep digital flexor tendon showed fibril formation and fibrocartilaginous metaplasia. CONCLUSIONS: Deep erosions of the palmar aspect of the navicular bone are more easily diagnosed by standing low field MR imaging than by conventional radiography. The lesions involve degeneration of the palmar fibrocartilage with underlying osteonecrosis and fibroplasia affecting the subchondral compact bone and medulla, and carry a poor prognosis for return to performance. POTENTIAL RELEVANCE: Diagnosis of shallow erosive lesions of the palmar fibrocartilage may allow therapeutic intervention earlier in the disease process, thereby preventing progression to deep erosive lesions.
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