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?
Authors: Whitlock J, Dixon J, Sherlock C, Tucker R, Bolt D M, Weller R
Journal: The Veterinary record
Summary
# Editorial Summary For over 60 years, equine foot radiography has included two separate dorsoproximal-palmarodistal oblique (DPr-PaDiO) views—one optimised for the distal phalanx and another for the navicular bone—despite significant advances in digital and computed radiography systems with sophisticated post-processing capabilities. Whitlock and colleagues compared the diagnostic quality of traditionally acquired navicular-optimised images against distal phalanx radiographs that had been digitally manipulated post-acquisition to visualise the navicular bone, presenting 30 images to four experienced clinicians who graded them on a three-point scale (1=textbook, 2=diagnostic, 3=non-diagnostic). The researchers found no statistically significant difference in diagnostic quality between the two approaches, suggesting that post-processing techniques available in modern systems can adequately compensate for exposure and centring parameters optimised for one anatomical structure when visualising another. This finding challenges a long-established protocol, indicating that practitioners using computerised radiography can confidently obtain a single DPr-PaDiO view centred on the distal phalanx, then digitally manipulate it for navicular assessment, thereby reducing exposure time, radiation dose to patient and operator, and unnecessary repeat radiographs.
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Practical Takeaways
- •You can obtain a single DPr-PaDiO view optimized for the distal phalanx and use post-processing to visualize the navicular bone, eliminating the need for a second radiograph
- •This streamlined approach saves time during radiographic examinations and reduces radiation exposure without compromising diagnostic quality
- •Modern computerized radiography systems make this protocol change feasible for equine foot radiography series
Key Findings
- •No significant difference in diagnostic quality was found between navicular-optimized DPr-PaDiO radiographs and post-processed distal phalanx images when assessed by four clinicians
- •Single DPr-PaDiO radiograph of the distal phalanx with appropriate post-processing can replace the traditional two-image protocol
- •Protocol modification reduces radiographic study time and decreases radiation exposure to patient and personnel