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Pedal Osteitis in Horses

By

James K. Belknap

, DVM, PhD, DACVS, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University

Last full review/revision Sep 2015 | Content last modified Oct 2015

Pedal osteitis is a radiographic finding of demineralization of the solar margin of the distal phalanx, commonly associated with widening of vascular channels near the solar margin, which is best observed on a 65° proximal-distal dorsopalmar radiographic view. Although the term is usually used to describe changes in the dorsal distal (toe) solar margin, it can be used to describe bone resorption of any aspect of the solar margin of the distal phalanx. The bony resorption usually occurs due to chronic or repeated pressure and/or inflammation of the affected region. The resorption can be focal due to a focal lesion such as a keratoma, or it can be more diffuse in states such as chronic toe bruising, in which the entire distal margin of the toe may appear “moth-eaten” due to extensive bone resorption at the solar margin. Resorption in the toe region commonly occurs in chronic laminitis cases in which displacement of the distal phalanx results in inadequate sole depth between the ground surface and solar margin of the distal phalanx, resulting in chronic trauma and inflammation of that region of the phalanx and surrounding soft tissue (ie, sole bruising or chronic subsolar sepsis). Because the bone resorption is usually permanent, the radiographic finding does not indicate current pathology and may be due to a pathologic state that occurred years ago. Therefore, it is essential that a thorough examination be performed, including application of hoof testers to the entire solar margin of the foot and a lameness examination with nerve blocks if lameness exists. (The entire solar surface, including the toe, will be anesthetized with a palmar digital nerve block.)

Navicular disease is an important differential diagnosis to pedal osteitis–associated toe bruising, because toe bruising is also commonly bilateral and both conditions respond to a palmar digital nerve block. Radiography is helpful in diagnosis and in differentiation from navicular disease. Pedal osteitis associated with chronic subsolar abscess is usually aseptic, with the sepsis isolated to the soft tissue. Radiographic signs of sequestration or severe focal lucency in the same region as the subsolar sepsis may indicate septic pedal osteitis, but lucency can also be an artifact caused by subsolar gas once an abscess is drained (an unopened abscess usually has a tissue density). Curettage of the affected distal phalanx should be avoided unless it is documented to be septic.

Local treatment (ie, curettage of the affected area) is necessary only if there is an active septic process associated with the radiographic changes of pedal osteitis. General treatment of nonseptic cases should be directed at the primary disease that caused the resorption (eg, corrective shoeing for chronic laminitis cases with distal phalanx displacement that predisposes to solar margin bruising).

OTHER TOPICS IN THIS CHAPTER

Lameness in Horses
Overview of Lameness in Horses
The Lameness Examination in Horses
Imaging Techniques in Equine Lameness
Arthroscopy in Equine Lameness
Regional Anesthesia in Equine Lameness
Disorders of the Foot in Horses
Osseous Cyst-like Lesions in the Distal Phalanx in Horses
Bruised Sole and Corns in Horses
Canker in Horses
Fracture of Navicular Bone in Horses
Fracture of Distal Phalanx in Horses
Keratoma in Horses
Laminitis in Horses
Navicular Disease in Horses
Pedal Osteitis in Horses
Puncture Wounds of the Foot in Horses
Pyramidal Disease in Horses
Quittor in Horses
Quarter Crack in Horses
Scratches in Horses
White Line Disease in Horses
Sheared Heels in Horses
Sidebone in Horses
Thrush in Horses
Disorders of the Pastern and Fetlock
Fractures of the First and Second Phalanx in Horses
Fractures of the Proximal Sesamoid Bones in Horses
Osteoarthritis of the Proximal Interphalangeal Joint in Horses
Palmar/Plantar Metacarpal/Metatarsal Nonadaptive Bone Remodeling in Horses
Sesamoiditis in Horses
Chronic Proliferative Synovitis in Horses
Digital Sheath Tenosynovitis in Horses
Disorders of the Metacarpus in Horses
Tendinitis in Horses
Suspensory Desmitis in Horses
Inferior Check Desmitis in Horses
Bucked Shins in Horses
Exostoses of the Second and Fourth Metacarpal Bones in Horses
Fractures of the Small Metacarpal (Splint) Bones in Horses
Fracture of the Third Metacarpal (Cannon) Bone in Horses
Disorders of the Carpus in Horses
Fracture of the Carpal Bones in Horses
Subchondral Bone Disease of the Third Carpal Bone in Horses
Tearing of the Medial Palmar Intercarpal Ligament in Horses
Osteoarthritis of the Carpus in Horses
Distal Radial Exostosis and Osteochondroma of the Distal Radius in Horses
Carpal Hygroma in Horses
Rupture of the Common Digital Extensor Tendon in Horses
Disorders of the Shoulder in Horses
Developmental Diseases of the Shoulder in Horses
Fractures of the Shoulder in Horses
Bicipital Bursitis in Horses
Infection of the Shoulder in Horses
Suprascapular Neuropathy in Horses
Osteoarthritis of the Shoulder in Horses
Disorders of the Elbow in Horses
Developmental Orthopedic Disease in the Elbow of Horses
Fractures of the Elbow in Horses
Osteoarthritis of the Elbow in Horses
Collateral Ligament Injury in the Elbow of Horses
Disorders of the Metatarsus in Horses
Bucked Shins/Dorsal Cortical Fractures of the Third Metatarsal Bone in Horses
Exostoses of the Metatarsal Bones in Horses
Diaphyseal Fracture of the Third Metatarsal Bone in Horses
Incomplete Longitudinal Fractures of the Plantar Aspect of the Third Metatarsal Bone in Horses
Focal Bone Reaction and Avulsion Fractures of the Third Metatarsal Bone in Horses
Fractures of the Second and Fourth Metatarsal Bones in Horses
Enostosis-like Lesions of the Third Metatarsal Bone in Horses
Disorders of the Tarsus in Horses
Failure of Ossification of the Distal Tarsal Bones in Horses
Osteoarthritis of the Distal Tarsal Joints in Horses
Osteoarthritis of the Talocalcaneal Joint in Horses
Osteoarthritis of the Tarsocrural Joint in Horses
Synovitis/Capsulitis of the Tarsocrural Joint in Horses
Osteochondrosis of the Tarsocrural Joint in Horses
Osteitis of the Calcaneus in Horses
Fractures of the Distal Tarsal Bones in Horses
Fracture of the Talus in Horses
Fracture of the Fibular Tarsal Bone (Calcaneus) in Horses
Fracture of the Lateral Malleolus of the Tibia in Horses
Tarsal Joint Luxation in Horses
Desmitis of the Collateral Ligaments of the Tarsus in Horses
Rupture of the Fibularis (Peroneus) Tertius in Horses
Stringhalt
Curb in Horses
Disorders of the Tarsal Sheath in Horses
False Thoroughpin in Horses
Luxation of the Superficial Digital Flexor Tendon from the Tuber Calcanei in Horses
Gastrocnemius Tendinitis in Horses
Calcaneal Bursitis in Horses
Capped Hock
Disorders of the Stifle in Horses
Osteochondrosis of the Stifle in Horses
Subchondral Cystic Lesions in Horses
Meniscus and Meniscal Ligament Injuries in Horses
Cranial and Caudal Cruciate Ligament Injuries in Horses
Collateral Ligament Injuries in Horses
Intermittent Upward Fixation of the Patella and Delayed Patella Release in Horses
Fragmentation of the Patella in Horses
Patellar Luxation in Horses
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Lameness
The lameness examination is an important method to identify musculoskeletal abnormalities. Which of the following abnormalities is NOT observed during a physical and lameness exam? 
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