A novel radiographic projection for the detection of sagittal plane slab fracture of the equine third carpal bone.
Authors: Ramzan P H L
Journal: Equine veterinary journal
Summary
# Editorial Summary: Novel Radiographic Projection for Third Carpal Bone Fractures Sagittal plane slab fractures of the equine third carpal bone represent a significant diagnostic challenge, as conventional radiographic views frequently fail to reveal these clinically important lesions in racehorses. Ramzan's retrospective analysis identified eight cases over a four-year period where fractures were visible only on a dorsoproximal lateral-palmarodistal medial oblique (DPrL-PDiMO) projection but remained invisible on the standard dorsoproximal-dorsodistal oblique (DPr-DDiO) view. The DPrL-PDiMO projection achieves superior visualisation by altering the beam angulation to better demonstrate the sagittal plane of the third carpal bone without superimposition of surrounding carpal structures. For veterinary practitioners investigating lameness or suspicion of carpal injury in racing stock, this supplementary projection offers a practical means of detecting fractures that could otherwise be missed on routine radiographs, potentially preventing catastrophic failure during training or competition. Including this view in the standard carpal radiographic protocol—particularly when clinical signs warrant further investigation despite negative conventional projections—warrants serious consideration in the diagnostic workup of racehorses with carpal pathology.
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Practical Takeaways
- •If standard carpal radiographs appear normal but lameness and clinical signs suggest carpal fracture, request the DPrL-PDiMO oblique projection to improve diagnostic sensitivity
- •This novel projection may prevent missed diagnoses of serious sagittal slab fractures in racing stock, potentially avoiding catastrophic fracture progression
- •Work with your radiographer to ensure this projection is included in carpal imaging protocols for suspected fracture cases
Key Findings
- •Eight cases of sagittal third carpal bone fractures were invisible on standard DPr-DDiO projections but visible on the novel DPrL-PDiMO projection
- •Conventional radiographic projections can fail to detect serious equine third carpal bone fractures
- •The DPrL-PDiMO projection demonstrated utility in investigating suspected carpal injury in Thoroughbred racehorses