Navicular bursitis refers to inflammation of the navicular bursa, the small synovial structure that lies between the [DDFT](/anatomy/deep-digital-flexor) and the fibrocartilage-covered flexor surface of the [navicular bone](/anatomy/navicular-bone-distal-sesamoid-right-forelimb), providing lubrication and shock absorption. While bursal inflammation or effusion frequently occurs as part of the broader podotrochlear syndrome ([Navicular syndrome (podotrochlosis)](/conditions/navicular-syndrome-podotrochlosis)), primary or isolated navicular bursitis is less common. Aseptic bursitis arises from repetitive friction, strain, or biomechanical overload within the apparatus. Septic (infectious) bursitis is a distinct and serious entity, usually resulting from penetrating solar injury (nail, sharp object, or deep wound) that introduces bacteria directly into the bursa; it can rapidly progress to osteomyelitis of the [navicular bone](/anatomy/navicular-bone-distal-sesamoid-right-forelimb) or involve adjacent structures such as the [DDFT](/anatomy/deep-digital-flexor) sheath or [coffin bone](/anatomy/coffin-bone-distal-phalanx-p3) joint. ## Causes & Risk Factors Aseptic: Repetitive stress or part of degenerative apparatus disease. Septic: Penetrating wounds to the frog or sole, especially in horses worked on uneven or debris-laden surfaces, or those with thin soles or poor hoof quality. Delayed wound care or inadequate tetanus prophylaxis increases risk. ## Diagnosis Clinical exam, history, and imaging. Ultrasound or MRI can demonstrate bursal distension, synovial thickening, or debris. For suspected septic cases, bursal fluid analysis (cytology, culture, protein) via ultrasound-guided aspiration is critical. Radiographs assess concurrent bone involvement or foreign material. Bursoscopy provides both diagnostic confirmation and therapeutic access. ## Treatment Aseptic bursitis is managed as part of the podotrochlear syndrome: corrective farriery, rest, NSAIDs, and targeted bursal or DIP joint injections. Septic bursitis demands aggressive intervention: broad-spectrum systemic antibiotics, local antimicrobial delivery (intravenous regional limb perfusion), and surgical lavage/debridement via navicular bursoscopy or bursotomy to remove infected tissue, fibrin, and debris. Drains or repeat lavages may be required. Supportive shoeing and prolonged rest follow. ## Prognosis Aseptic cases carry a similar guarded-to-fair outlook to the syndrome and often respond well to multimodal management. Septic navicular bursitis has a more guarded prognosis for athletic return, though survival and pasture soundness are achievable with prompt, aggressive treatment. Complications include chronic adhesions, navicular osteomyelitis or sequestration, spread of infection, and progressive degenerative changes. ## Prevention For aseptic: Same principles as navicular syndrome prevention. For septic: Diligent hoof care and prompt, thorough treatment of any solar penetrating wounds, including professional debridement, antibiotics when indicated, and tetanus protection. This information is for educational purposes only. Always consult with a licensed veterinarian for diagnosis and treatment of your horse.
- Aseptic cases present similarly to navicular syndrome: heel pain, shortened stride, pointing, and positive response to blocks - Bursal effusion detectable on ultrasound or MRI - Septic cases show more acute, severe lameness, heat, swelling, and systemic signs (fever, lethargy) if infection spreads - Marked sensitivity over the frog or heel - Sometimes visible or draining tracts from a penetrating wound - Horses with septic bursitis often have a history of recent solar trauma - Related conditions: [Navicular syndrome (podotrochlosis)](/conditions/navicular-syndrome-podotrochlosis), [Cyst-like lesions of the navicular bone](/conditions/cyst-like-lesions-of-the-navicular-bone)
Navicular bursitis refers to inflammation of the navicular bursa, the small synovial structure that lies between the [DDFT](/anatomy/deep-digital-flexor) and the fibrocartilage-covered flexor surface of the [navicular bone](/anatomy/navicular-bone-distal-sesamoid-right-forelimb), providing lubrication and shock absorption. While bursal inflammation or effusion frequently occurs as part of the broader podotrochlear syndrome ([Navicular syndrome (podotrochlosis)](/conditions/navicular-syndrome-podotrochlosis)), primary or isolated navicular bursitis is less common. Aseptic bursitis arises from repetitive friction, strain, or biomechanical overload within the apparatus. Septic (infectious) bursitis is a distinct and serious entity, usually resulting from penetrating solar injury (nail, sharp object, or deep wound) that introduces bacteria directly into the bursa; it can rapidly progress to osteomyelitis of the [navicular bone](/anatomy/navicular-bone-distal-sesamoid-right-forelimb) or involve adjacent structures such as the [DDFT](/anatomy/deep-digital-flexor) sheath or [coffin bone](/anatomy/coffin-bone-distal-phalanx-p3) joint. ## Causes & Risk Factors Aseptic: Repetitive stress or part of degenerative apparatus disease. Septic: Penetrating wounds to the frog or sole, especially in horses worked on uneven or debris-laden surfaces, or those with thin soles or poor hoof quality. Delayed wound care or inadequate tetanus prophylaxis increases risk. ## Diagnosis Clinical exam, history, and imaging. Ultrasound or MRI can demonstrate bursal distension, synovial thickening, or debris. For suspected septic cases, bursal fluid analysis (cytology, culture, protein) via ultrasound-guided aspiration is critical. Radiographs assess concurrent bone involvement or foreign material. Bursoscopy provides both diagnostic confirmation and therapeutic access. ## Treatment Aseptic bursitis is managed as part of the podotrochlear syndrome: corrective farriery, rest, NSAIDs, and targeted bursal or DIP joint injections. Septic bursitis demands aggressive intervention: broad-spectrum systemic antibiotics, local antimicrobial delivery (intravenous regional limb perfusion), and surgical lavage/debridement via navicular bursoscopy or bursotomy to remove infected tissue, fibrin, and debris. Drains or repeat lavages may be required. Supportive shoeing and prolonged rest follow. ## Prognosis Aseptic cases carry a similar guarded-to-fair outlook to the syndrome and often respond well to multimodal management. Septic navicular bursitis has a more guarded prognosis for athletic return, though survival and pasture soundness are achievable with prompt, aggressive treatment. Complications include chronic adhesions, navicular osteomyelitis or sequestration, spread of infection, and progressive degenerative changes. ## Prevention For aseptic: Same principles as navicular syndrome prevention. For septic: Diligent hoof care and prompt, thorough treatment of any solar penetrating wounds, including professional debridement, antibiotics when indicated, and tetanus protection. This information is for educational purposes only. Always consult with a licensed veterinarian for diagnosis and treatment of your horse.
- Aseptic cases present similarly to navicular syndrome: heel pain, shortened stride, pointing, and positive response to blocks - Bursal effusion detectable on ultrasound or MRI - Septic cases show more acute, severe lameness, heat, swelling, and systemic signs (fever, lethargy) if infection spreads - Marked sensitivity over the frog or heel - Sometimes visible or draining tracts from a penetrating wound - Horses with septic bursitis often have a history of recent solar trauma - Related conditions: [Navicular syndrome (podotrochlosis)](/conditions/navicular-syndrome-podotrochlosis), [Cyst-like lesions of the navicular bone](/conditions/cyst-like-lesions-of-the-navicular-bone)