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Abnormalities of the facies flexoria of the distal phalanx (FF) of the horse associated with podotrochlear syndrome have been scarcely described in the literature. The objective of this retrospective study was to determine correlation between modification of the FF and lesions of the podotrochlear apparatus. This study includes 100 horses referred for forelimb lameness that underwent a standardized magnetic resonance (MR) imaging protocol of the affected foot. Of the 100 MR studies, 74 had podotrochlear lesions and 26 free of podotrochlear lesions served as controls. A comparison of the FF compact bone thickness between affected and control feet was performed. Presence and location of a deep digital flexor tendon (DDFT) lesion was noted. Grading systems were used to score: FF osseous resorption, FF bone marrow lesion, FF sclerosis and abnormalities of the navicular bursa and the distal interphalangeal joint. Compact bone thickness of the FF was not increased in case of tendinopathy of the DDFT or other podotrochlear lesions (P = .86). Significant correlation was observed between osseous resorption of the FF at the level of the distal recess of the navicular bursa and synovial proliferation of the navicular bursa (P = .05). Compact bone thickening at the DDFT enthesis is not predictive of podotrochlear syndrome and should rather be considered as an interindividual anatomical variation. Navicular bursitis may play a role in osseous resorption of the FF.