3.Radiology of the forelimb and the neck

Question 1

Indications for X-rays of a horse limb:

Answer 1

• Penetrating injuries
• Laminitis
• Navicularbursa injecton
• For the farrier –hoof balance, sole thickness

Question 2

Preparation before taking X-ray of the limb:

Answer 2

Remove shoe, thorough paring and cleaning, packing with radiolucent material to avoid air artefacts (play doh)

Question 3

What are the standard views?

Answer 3

For lamness examination: LM, Dpa, DPrPaDiO of the pedal and navicular bones, oblique and skyline view.

Laminitis: LM

For the farrier: LM,DPa

Question 4

Decribe how the the lateromedial view works:

Answer 4

• Straight limb
• Xray beam parallel with the heel bulbs
• Centre in the region of the navicular bone
• Halfway between dorsal and palmar
• 1 cm distal to the coronary band
• Orientation of the distal phalanx
• Distal interphalangeal joint margins
• Palmar processes / ossified cartilages
• Tip and solar margin of distal phalanx
• Navicular bone
• Shape (elongation, modelling)
• Corticomedullar definition
• Thickness of the dorsal hoof wall and the sole

Question 5

Describe the dorsopalmar view:

Answer 5

• Foot on a block, pulled forward
• Limb straight from the front
• Centre midway between the coronary band and the ground
• Horizontal X-ray beam, at right angle to the heel bulbs
• Orientation of the distal phalanx, thickness of the sole
• Ungular cartilages
• Solar margin of distal phalanx
• Proximal border of the navicular bone

Question 6

Describe DPrPaDiO – distal phalanx :

Answer 6

• Upright pedal view
• Hoof wall vertical on the block
• Centre at the level of the coronary band
• Standing on a block
• Beam at 65° to horzontal
• Margins of the distal phalanx
• Ungular cartilages
• Insertion site of CL DIP joint

Question 7

Describe DPrPaDiO – navicular bone

Answer 7

• Foot slightly pulled forward on the block
• Centre 1 cm distal to the coronary band
• Proximal border
• Distal border

Question 8

Describe the Palmaroproximal-Palmarodistal Oblique view

Skyline view of the navicular bone:

Answer 8

• Horse stands on a tunnel with foot positioned backwards
• Centre between the heel bulbs
• 45-70° to the horizontal, depending on the slope of the pastern and positioning

Question 9

Describe Dorso60°Lateral-PalmaroMedial Oblique and

Dorso60°Medial-Palmarolateral Oblique views

Answer 9

• Foot on a block, dorsal hoof wall vertical

Question 10

Navicular disease

Answer 10

Complex pathology, involves the navicular bone and associated structures:
• Navicular bursa
• Deep digital flexor tendon
• Distal sesamoidean impar ligament
• Collateral ligaments of the navicular bone
• Chondrosesamoidean ligament

X-rays cannot provide a complete picture
-But certain radiological changes suggest soft tissue involvement