Evaluation of clinical examination for differential diagnosis of lameness by navicular apparatus or heel pain in horses.

Abstract

To evaluation of clinical examination for differential diagnosis of navicular region pain from other forms of palmar heel pain in the forelimb in horses the present study was undertaken. Thirty four horses with lameness referable to the palmar aspect of the hoof based on their response to the palmar digital nerves analgesia were divided into 2 groups based on their response to both distal interphalangeal joint and navicular bursa analgesia. Horses that were profoundly improved by both analgesic blocks (distal interphalangeal joint and navicular bursa) were considered to have navicular region pain whereas, all other horses were considered to have other cause of palmar heel pain. The responses to various diagnostic tests such as hoof tester, distal limb flexion and toe wedge tests were compared between the groups. For all diagnostic tests, sensitivity, specificity and positive predictive values for navicular pain were calculated. According to the present study the single most accurate diagnostic test was analgesia of the distal interphalangeal joint for navicular region pain.