The Value of Hoof Radiographs

From baseline images to diagnosing complex cases, here’s why X rays should be key components of your horse’s hoof care plan

Radiographs have revolutionized medicine, veterinary or otherwise. In a little over a century, we have gained the ability to look inside a patient’s body and evaluate not just bony structures but also organs and soft tissues.

Veterinarians use radiology in their day-to-day practice. As an equine practitioner, I take radiographs on a very regular basis, with X rays of the hoof being the most common. In this article I’ll describe why hoof radiographs are important, how to use them, and the role they play in helping your horse feel and move better.

What’s in a Radiograph?

The outer part of the hoof capsule is made up of dense keratin, the same material that forms your fingernails. Inside you’ll find primarily the third phalanx (also known as the coffin or pedal bone) and some soft tissue structures. The coffin bone is attached to the hoof capsule by a network of laminae, a scaffolding of soft tissue between the wall and bone.

Radiographs of the hoof also include the second and first phalanx (the short and long pastern bone, respectively). If the horse is on the smaller side, you might see the fetlock joint on the same image.

Betsy Lordan, DVM, CJF, TE, a veterinary podiatrist with SRH Veterinary Services, in Ipswich, Massachusetts, explains the usefulness of hoof radiographs for diagnosing issues and monitoring anatomy: “While we can determine a lot about horses looking at their gross conformation, things are not always what they seem. Using radiographs, we can improve upon those clinical exam findings and fine-tune details which are not as easy to manipulate on the outside of the hoof capsule. Some parameters we evaluate include bony column alignment, sole depth, palmar angle (the angle the bottom of the coffin bone makes with the ground), and evidence of diseases such as arthritis or navicular syndrome (podotrochlosis).”

Baseline Hoof Radiographs

More often than not, veterinarians recommend hoof radiographs because they have narrowed the cause of a clinical lameness to the foot, typically using diagnostic analgesia, or nerve blocks. They use radiographs to evaluate the bony column for pathology (disease or damage). Sometimes, however, clients ask for a baseline set of radiographs on a sound horse, often during a prepurchase exam or on a newly purchased mount.

“Baseline radiographs are very helpful because the hoof is not a static ­structure—it will morph and change over time and adapt to a variety of circumstances,” says Lordan. “If you’re lucky, you will buy a horse that never has a foot or lameness problem, but the odds are slim.”

Horses can have individual anatomic differences that might have varying clinical significance. Having a good set of baseline radiographs when the horse is sound can help your veterinarian distinguish whether those variations are relevant to a clinical condition, she says. They can also help your veterinarian track the progression of a condition and provide prognostic information.

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