Case Study 
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History: 
Patient is an eight year old Warmblood mare with a history of an intermittent right front lameness of six months duration.  The  lameness blocked to a posterior digital nerve block.  Radiographs were within normal limits in April.  Horse was originally imaged in April of 2009 and again in September of 2009.
Navicular Degeneration Axial                                                         
 
MRI Findings:
April 2009 Exam
Increased signal was noted in the medullary cavity of the navicular bone.  A small erosive lesion was also noted on the distal border of the navicular bone just lateral to midline.  There was a diffuse increased signal throughout the toe of P3 on STIR sequences consistent with pedal osteitis.  A bone bruise was also noted in distal P2 and a tear was noted in the deep digital flexor tendon.     
 
September 2009 Exam
The edema previously noted in the medullary cavity of the navicular bone has formed a well defined cyst like lesion that extends to the flexor surface.  Sclerosis surrounds the cyst like lesion.  Pedal osteitis has improved.  The previous changes in the deep digital flexor tendon had significantly improved and the P2 edma previously noted had resolved. 
 
Navicular Degeneration 
Impressions and Recommendations:
The most problematic finding is the significant advancement in the size and shape of the flexor cortical erosive lesion and the development of a more cystic lesion within the navicular bone.  Prognosis as an athlete is guarded given the size and shape of the navicular pathology.  Recommendations for treatment included injecting the erosive cyst with a cortisone or possible forage of the navicular bone.  This study was interesting in that we were able to chronicle the impressive deterioration of the cystic change within the navicular bone in a short time interval.  Is this traumatic or another etiology?
Animal Imaging 
Animal Imaging is a veterinary referral diagnostic center in Irving offering MRI, Scintigraphy, Radiology, Fluoroscopy and Ultrasound for companion animals and equine patients. 

This case study is made possible through an educational grant from 

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Jake Hersman, DVM            Robert Cole, DVM, DACVR           Susan Willenbrock
Managing Partner                 Imaging Director                           Office Manager
(972) 869-2180                     (972) 869-2180                             (972) 869-2180