Patient History/PE:​

• 5-year-old QH mare with bilateral forelimb lameness.​

• Previous diagnoses: navicular syndrome and left front navicular bone cyst.​

• Coffin joint injections (steroid and arthramid) no longer effective.​

• Responds to anti-inflammatories but not currently on any.​

Exam findings:​

• 3/5 LF lame.​

• Positive to distal limb flexions of bilateral forelimbs.​

• PD nerve block on LF switched lameness to 1/5 RF.​

• Abaxial block on LF resulted in 2-3/5 RF lameness.​

​Diagnosis:​

• Bilateral podotrochlear apparatus abnormalities:​

• Moderate to marked navicular bone changes (greater on LF).​

• LF deep digital flexor tendinopathy with dorsal border tears near navicular bursa.​

• Mild bilateral deep digital flexor and impar enthesopathy.​

• Mild bilateral distal interphalangeal joint effusion.​

• Subtle subchondral contour defect in RF distal P2.​

• Minimal bilateral fetlock osteoarthritis.​

Treatment/Outcome: Owner elected to discuss retirement options for the mare.​