Technical innovation changes standard radiographic protocols in veterinary medicine: is it necessary to obtain two dorsoproximal-palmarodistal oblique views of the equine foot when using computerised radiography systems?

The research article investigates the impact of technological advancements in radiography systems and evaluates whether it is still necessary to obtain two separate images of a horse’s foot from varying oblique angles for diagnostic purposes. It concludes that a single image, following post-acquisition manipulation, delivers similar diagnostic value as the two-image protocol, leading to potential time and radiation exposure reduction.

Introduction and Background

• Traditionally, two separate dorsoproximal-palmarodistal oblique (DPr-PaDiO) radiographs have been taken as part of the standard procedure for capturing the equine foot. One image focused on the distal phalanx, while the other was aimed at the navicular bone.
• This practice was based on the imaging capabilities available during the 1950s. However, the advent of computing technology has dramatically improved the capabilities of radiography, potentially rendering the two-image protocol redundant.
• The research aims to scrutinize this dual image practice in light of the recent advancements in computed and digital radiography.

Methodology

• Thirty images were captured using a computerized radiography system with exposures, centring, and collimation considered ideal for the navicular bone. These images were compared with images acquired for the distal phalanx and subsequently adjusted post-acquisition to highlight the navicular bone.
• The images’ quality was assessed by four clinicians using a grading scale from 1 to 3, where 1 represented textbook quality and 3 indicated a non-diagnostic image.

Results and Conclusion

• The results demonstrated that there was no significant difference in the diagnostic quality of the original navicular bone images and the manipulated distal phalanx images.
• Based on these findings, the study concluded that a single DPr-PaDiO radiograph of the distal phalanx is sufficient when it is subsequently processed and manipulated to highlight the navicular bone.
• This updated protocol has considerable benefits over the traditional two-image practice. It not only reduces the time required for the radiographic study but also decreases the exposure of the patient and personnel to radiation.