Subchondral cystic lesions (SCLs) can involve most bone segments but are located frequently in the medial femoral condyle (MFC) and less frequently in the phalanges, metacarpus/metatarsus, radius, scapula, tibia and carpal bones. 1 Recently, a study demonstrated the presence of SCLs in cervical vertebrae. 2 SCLs located close to or in communication with a joint, especially in weight-bearing locations, are likely to cause lameness. 1,3,4 The pathogenesis is controversial; several theories have been hypothesised and include the hydraulic theory, where synovial fluid is pulled through the subchondral bone into the cancellous bone via a slit-like lesion in the cartilage; 5 and the inflammatory theory, in which SCLs become lined with fibrous tissue that secretes inflammatory mediators including PGE2 and IL-6. 6 SCLs can also develop following primary damage of the subchondral bone with collapse of the articular surface. 5,7 Finally, osteochondrosis or a combination of the aforementioned processes are proposed causes of SCLs development. 1,[5][6][7] In humans, venous obstruction to