Equine Health Update EHU 2020 Issue 02 | Page 31

Radiography| EQUINE Field Guide To: The Flexed Dorsopalmar Radiographic Projection Of The Fetlock Piet Ramzan The flexed dorsopalmar (plantarodorsal for hindlimb) projection of the fetlock is arguably the most important radiographic technique for the early detection of potentially catastrophic fracture pathology in the athletic horse. The projection is used specifically when lesions of the palmaro/plantarodistal condyles (highlighted in red below) are suspected. It is the only radiographic projection that permits visualisation of the ‘fissure’ (‘unicortical’) fractures that often precede complete condylar fracture. they progress to complete fracture. Only a small subset of injuries are radiologically silent or ambiguous and require MRI for diagnosis. The projection is also used for the detection of palmar/ plantar osteochondral disease (‘POD’ lesions/‘bone bruising’), although unless pathology is advanced the sensitivity and specificity of radiography for this condition is generally poor. For both fissure fracture and POD lesion detection, multiple lesion-oriented exposures may be required. With good clinical vigilance and radiographic technique many fetlock condylar injuries can be detected before • Volume 22 Issue 02 | June 2020 • 31