Radiography of the equine fetlock

Radiography of the equine fetlock

A case study explaining the indications, preparations and techniques required to carry out a radiograph of the Fetlock joints in equine practice. For veterinary use.

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Radiography of the equine fetlock

Equine Radiography – the Metacarpo- and Metatarsophalangeal Joints (Fetlocks): ‘Standard Views’


  • Investigation of lameness localized to the region of the fetlock joint (as determined by perineural/intra-articular anaesthesia).
  • Pre-purchase examinations.
  • Investigation of traumatic/penetrating wounds to the fetlock region.
  • Assessment of angular limb deformities.
  • Monitoring progression of disease.


  • Ensure the hair coat is clean to minimize the likelihood of artefacts appearing on the radiograph.
  • Particularly nervous horses may need to be sedated, although radiography of this region is usually well-tolerated by most horses.
  • The horse should be standing as square as possible, evenly weight-bearing on all four limbs, with the cannon bone of the limb to be radiographed as vertical as possible in both planes.
  • Remember that use of markers is very important – LEFT and RIGHT but also FORE LIMB and HIND LIMB (easily added on modern digital systems). By convention the L/R markers are placed either laterally on a DP view, or dorsally on lateral and oblique views.


  • Four or five ‘standard’ views:
    • lateromedial
    • dorsopalmar
    • dorsolateral-palmaromedial oblique
    • dorsomedial-palmarolateral oblique
    • (flexed lateromedial)
  • Various other ‘specialist’ views for identifying specific lesions or when the ‘standard’ views have found no pathology.
  • Note that the techniques are the same for the hind limb as for the fore limb but for the sake of brevity only the fore limb terminology is given below.


  • Lateromedial view (LM):


  • the x-ray beam should be horizontal, and perpendicular to the dorsopalmar axis of the leg at the level of the fetlock joint.
  • centre on the joint space.
  • beware animals standing with the limb slightly turned out (or in) – a true lateral view is necessary to fully evaluate the sagittal ridge of the cannon bone.
  • Dorsopalmar view (DP):


  • center on the joint space.
  • a horizontal x-ray beam will lead to superimposition of the proximal sesamoid bones on the joint space, but…
  • a dorsoproximal-palmarodistal angulation of 10-15o will prevent this from happening.
  • Dorsolateral-palmaromedial oblique (DLPMO):
    • highlights the dorsomedial and palmarolateral (abaxial) aspects of the joint, as well as the sesamoid bones.
    • the x-ray beam should be horizontal, and at a 45o angle to the dorsopalmar axis of the leg, aiming from a dorsolateral position towards a palmaromedial position.
    • center on the joint space.
  • Dorsomedial-palmarolateral oblique (DMPLO):

    • as for the DLPMO but from a dorsomedial position aiming towards a palmarolateral position.
  • Flexed lateral:
    • highlights the articular surfaces of the proximal sesamoid bones.
    • raise the foot either by placing on a wooden block or by holding the toe with a gloved hand (to a height of 20-30cm).
    • center on the centre of the condyles of MC III.
    • remember to aim to get a true lateral view as with the standard LM view.
    • this view may require a lower mAs setting.

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