[The diagnostic value of the 'skyline' view for the radiographic study of the navicular bone in horses].
Authors: Zweers, Dik
Journal: Tijdschrift voor diergeneeskunde
Summary
Rose's palmaroproximal-dorsodistal (skyline) projection has long been considered a specialist radiographic view for navicular pathology, yet its clinical utility relative to the standard Oxspring dorsopalmar projection remained poorly defined. Zweers examined radiographs of 102 navicular bones from 66 lame horses with suspected navicular disease, comparing diagnostic information yielded by each projection independently and in combination. The skyline view provided essential diagnostic information in 27 cases (26%), including 15 cases where it offered unique insights unavailable on the Oxspring projection and 12 where it added value to that standard view; conversely, the dorsopalmar projection alone proved most valuable in only 11 cases (11%), with both projections providing equivalent information in the remaining 64 bones. These findings support the addition of skyline views to your standard navicular radiographic protocol—particularly when clinical lameness localisation conflicts with dorsopalmar findings, when Oxspring images show poorly defined lesions of uncertain significance, or when initial diagnoses fail to explain clinical presentation. This selective rather than routine approach preserves cost-effectiveness whilst substantially improving diagnostic confidence in cases where standard projections leave uncertainty.
Read the full abstract on PubMed
Practical Takeaways
- •Add the skyline projection to your standard navicular radiographic protocol when lameness localizes to the navicular area but findings on routine views are inconclusive
- •Use skyline view as a problem-solving tool when clinical signs and standard radiographs don't align, rather than as a routine first-line view
- •The skyline projection may clarify lesions of uncertain significance seen on the Oxspring view, improving diagnostic confidence and treatment decisions
Key Findings
- •The skyline projection provided essential diagnostic information in 27 of 102 navicular bones (26.5%), with 15 cases offering independent diagnostic value beyond Oxspring's view
- •The Oxspring dorsopalmar projection was the most important diagnostic view in only 11 cases (10.8%)
- •In 64 navicular bones (62.7%), both projections provided equal diagnostic value
- •Skyline view is particularly valuable when clinical and radiographic findings are discordant or when ill-defined lesions appear on Oxspring projection