A detailed histopathological study of the distal third metacarpal bone of Thoroughbred racehorses was undertaken to characterize lesions observed previously on magnetic resonance imaging (MRI). The bones were selected and grouped on the basis of MRI features. Representative sections in different planes were processed for histopathology. All lesions observed in the articular cartilage (AC) and subchondral bone (SCB) were recorded and graded with a scoring system, based partially on the Osteoarthritis Research Society International grading system. The scoring system included the severity of the lesion. Descriptive statistics and linear mixed effects models were performed. A positive correlation was observed between the severity of histopathological changes in the superficial and deeper osteochondral tissues, and between the number of race starts and AC score. Age was not correlated with AC or SCB score. A moderate variation in AC and SCB scores was observed between the groups; however, there were differences within individual bones. Bones with focal palmar necrosis (FPN) showed significant differences in the histological scoring of the AC compared with bones without FPN. Bones with incomplete fractures or larger areas of bone remodelling showed significant differences in SCB pathology when compared with bones with FPN. Haematoidin was detected in areas with excessive SCB and cancellous bone sclerosis and/or irregular bone density. This finding is suggestive of poor blood perfusion in these areas.

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