Hot Topics in Hoof Care, Part 3: The Role of Imaging

Careful preparation and proper foot positioning are critical to producing high-quality foot radiographs.

Photo: Kevin Thompson/The Horse

Podiatry and managing problem hooves require the veterinarian and farrier to work in concert to diagnose, trim, and shoe, depending on the condition. Both individuals rely on imaging to evaluate the horse’s hoof, said Mark Silverman, DVM, MS, of Sport Horse Veterinary Services, in Rancho Santa Fe, California, who described the uses and benefits of different imaging modalities.

“Routine imaging provides us the ability to review the results of interventions and chart changes in foot conformation over time,” he said.

Radiography is, as Silverman said, the “bread and butter” of podiatry imaging. X rays show the foot’s internal structures, especially bone, as well as some soft-tissue structures. The basic foot views, which are often standard for prepurchase exams, include dorsal-to-palmar (front-to-back) and lateral-to-medial (side-to-middle).

Careful preparation and proper foot positioning are critical to producing high-quality foot radiographs, Silverman added. That includes the use of blocks, which are customized pieces of wood veterinarians use to set up X ray shots.

Additional Resources

Read about other topics covered during the 2015 American Association of Equine Practitioners’ Podiatry Workshop:

“Using blocks that are designed to work with the specific radiographic generator being used is important, as is using standardized film focal distance and beam alignment,” Silverman said. It is critical to optimize bony alignment for each limb to produce reliable radiographs, taking into consideration any conformation quirks when doing so.

“Taking high-quality radiographs for podiatry requires a consistent, repeatable protocol,” Silverman said. “Foot placement, machine alignment, and metric evaluation of the images allow us to both evaluate our intervention and track results over time.”

Other useful imaging modalities for podiatry include:

  • Ultrasonography “Due to the nature of the hoof capsule and ultrasound’s limited ability to penetrate the hoof wall, other modalities can outperform this technology when looking for soft tissue details within the hoof,” Silverman said.
  • Nuclear scintigraphy This technique uses radioactive isotopes to locate areas of increased metabolic activity in soft tissue or bone. These areas “light up” in the image, indicating problem areas.
  • MRI This newest tool in the podiatrist’s kit allows veterinarians to evaluate bone, soft tissue, and fluid in the foot.

Standing MRI images allow veterinarians to evaluate bone, soft tissue, and fluid in the foot.

Photo: Kevin Thompson/The Horse


  • Computed tomography (CT) This technology offers a detailed look at the structures within the foot, using a series of computer-processed radiographs to create a 3-D image.
  • Thermography Infrared (IR) detectors map temperature changes, which show veterinarians possible changes in blood flow patterns within the hoof.
  • Venogram Veterinarians inject a vein in the foot with a contrast material and take X rays to evaluate blood flow, often when evaluating laminitis cases.
  • Digital photography Taking photographs of the hoof from various perspectives can help both veterinarian and farrier record, evaluate, and communicate hoof conformation and changes over time, Silverman noted.
  • High-speed video Finally, Silverman said, veterinarians can capture footage of a horse’s movement and evaluate it in slow motion to better visualize detail that might otherwise go unobserved.

About the Author

Michelle N. Anderson, Digital Managing Editor

Michelle Anderson serves as The Horse's digital managing editor. In her role, she produces content for our web site and hosts our live events, including Ask the Vet Live. A lifelong horse owner, Anderson competes in dressage and enjoys trail riding. She's a Washington State University graduate (Go Cougs!) and holds a bachelor's degree in communications with a minor in business administration and extensive coursework in animal sciences. She has worked in equine publishing since 1998. She currently lives with her husband on a small horse property in Central Oregon.

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