Involvement can be unilateral or bilateral depending on the cause. Causes of the entity are varied - it can occur as a primary or secondary condition. Treatment is often aimed at correcting the underlying condition that caused its development. Primary nonseptic pedal osteitis typically results from severe or chronic sole bruising sustained from repeated concussion during exercise on hard surfaces. Secondary nonseptic pedal osteitis can be the result of conformation faults or improper farrier work that have caused uneven weight bearing on the sole.
Hoof testers elicit positive responses between the sole and wall in diffuse or localized areas.
Lameness can vary in degrees of severity and is often exacerbated after exercise or shortly after trimming or shoeing. Sole bruising may not always be apparent, since foot opacity can prevent immediate visibility until the hemorrhage spreads into the epidermis distally and becomes apparent to the eye. Most of the time, chronic bruising is visible on the solar surface and horn hemorrhage can appear stippled because of the tubular and intertubular horn pattern. Radiographic changes are required to make a true diagnosis of both types of pedal osteitis. Bone demineralization that occurs in this disorder can often be difficult to detect in field x-rays, since numerous variables can affect a radiographic image, such as amperage and distance from the machine.