“Pulling a handful of films from the processor hoping a few of them are good enough and knowing full well that most will not be diagnostic is not only frustrating, but a tremendous financial black hole for all concerned,” said Ric Redden, DVM, in the first presentation of the 15th annual Bluegrass Laminitis Symposium January 21-23, 2002. This presentation on developing a useful radiographic protocol for analyzing the equine foot consisted mainly of videotaped radiographic procedure at Redden’s clinic, followed by in-depth analysis of X rays from all different angles. He discussed each radiograph in terms of how well they were taken and how well different angles showed particular structures.

X rays aren’t the only important part of a diagnosis, however: “The history and a thorough exam are far more important than any radiograph,” he commented. “The radiograph is just for confirming a diagnosis.”

Redden offered several tips for taking useful radiographs of the equine foot, including the following:

  • Keep the horse’s head straight to keep his hooves loaded evenly when taking the X rays.

  • Make sure to put both front or hind hooves on blocks to keep the hooves loaded evenly.

  • Radio-opaque paste is better than wire for marking the toe, as it follows the contour of the hoof like wire can’t.

  • A lateral X ray should only show one branch of the shoe—if it shows both, then your machine is too high or too low.

    To get a consistent distance from each foot to the X ray machine, measure it off the first time and then bend the end of a length of wire so it’s the same length. Using this wire to mark the distance for subsequent radiographs is much quicker than measuring it off with a tape.

  • Make sure you have everything you need at hand and easily accessible. It only takes moments to take 15-20 views if you’ve got everything set up correctly.

  • If you are going to pull a shoe off for X rays, make sure you do so with minimal impact on the hoof. Pull it nail by nail rather than using shoe pullers, and if the horse is sore to one nail more than another take note for further analysis.

  • Clean up the foot before radiographing it, including cleaning off mud, trimming off any shedding frog, etc. Dirt and shreds of shedding hoof give artifacts on radiographs. Cleaning up the central sulcus is especially important, because contamination along its deep cleft can cause a dark artifact that mimics a fracture. Don’t trim the foot, just clean it unless you have developed competent farrier skills.

  • Take some views exposed so they show soft tissue. If you can’t see the hoof capsule on balanced views, you’re not helping the farrier.

  • Redden prefers not to use play-dough packing, as it reduces detail.

Redden also described venogram technique (injecting radio-opaque dye in a blood vessel just above the hoof to visualize blood flow in the hoof) using video, emphasizing the short time frame for getting a useful image.

“You only have about 30-45 seconds to take the film with the venogram—you have to be quick and have everything ready,” he said. Tips for venogram procedure included making sure to get the tourniquet tight enough and rocking the heel upward briefly to allow perfusion of the anterior portion of the foot.

About the Author

Christy M. West

Christy West has a BS in Equine Science from the University of Kentucky, and an MS in Agricultural Journalism from the University of Wisconsin-Madison.

Stay on top of the most recent Horse Health news with FREE weekly newsletters from TheHorse.com. Learn More