UPDATE post 23 Armchair vets - weird hoof xray?

[fivestrideline]

Let’s play a game called Fracture or Weird Shadow!

While looking for a farrier I sent a potential option some X-rays of my horse’s feet and they asked “is that a fracture or a weird shadow?”. I’m following up with my vet but I’ve got a collection of rads of this horse, taken by 3 vets from 3 clinics on 3 machines on 3 different occasions (and at 3 different barns, actually). Only one has mentioned the “shadow”, and they weren’t really concerned. I just feel like this bone should be attached, as the bone on the other leg (and his hinds, and 2 of my friend’s horses’ rads) are in one piece.

So, shadow or fracture or normal or ???

Edited to add pics!

[WavyRider]

That does look like a fracture. Very curious if this horse is sound.

[fivestrideline]

Horse is not technically sound, but is sound at the walk which is all he’s allowed to do. We are currently rehabbing high suspensory on the same leg, found on same appointment as second set of X-rays May 2022. General lameness originally diagnosed in March 2022 by vet 1 as kissing spine and needing hock injections. I requested the xrays at that appointment for hoof balance and found NPA all around, which was deemed low priority.

Horse remained unsound, was diagnosed with suspensory injury by vet 2 in May after blocking and ultrasound. “Shadow” on X-ray at circled site mentioned but deemed a shadow and unconcerning.

Progress check ultrasound and balance X-rays in October done by vet 3. No mention of this area, just the need to continue working on the angles. Horse cleared to continue rehab plan.

I was tipped to the weird site on the X-rays after sending them to a new potential farrier about a week ago now, and I have no clue what I’m looking at, really.

Edited: clarity

[No1]

Type 1 wing fracture. https://www.turnerequinesportsmed.com/fracture_of_the_coffine_bone/

[endlessclimb]

I passed on a 2 year old with this fracture, found on a PPE. He was sound, but obviously not in work. That was about 6 years ago, and the horse doesn’t have any show record and has disappeared off the map. Maybe he’s fine, maybe he’s not. But that’s my experience.

[hybriseris]

Not an expert on hoof rads but I do read radiographs at work all day long and that’s in no way a shadow. Maybe on the first shot it’s less defined, but on the second two it doesn’t get more radiolucent than that.

I do think @No1 is on to something here and it’s interesting it’s on the same leg as the suspensory.

Think I’d have the farrier who pointed it out on your short list as well!

[IPEsq]

Looks like it’s displaced now too. Maybe not on the first one…hard to say.

[No1]

I think it’s less that it’s displaced now and more that the angles of the X-rays are different.

OP, how long have you owned this horse and do you have foot rads from the prepurchase? Or any other time before this lameness began?

[fivestrideline]

I’ve had this horse for 7 years, no PPE. No hoof rads pre-lameness, either. I had to beg and plead with the vet for the first set.

Horse has been in sporadic work due to moving around (we’d get going, hopping around 2’6”, and then he’d sit as I moved and looked for a new barn). It took a lameness locator and a few hours to pin it down, and the hoof/lower leg didn’t block out sound - only the high suspensory. Weird.

[fivestrideline]

I’m an attempt to post a pic directly, here’s a solar view of that foot. Not a great one, though.

I don’t think you can see anything. But now I know how to post pics! Thanks for the PM!

[IPEsq]

I think you’d need a solar view without shoes on.

[OverandOnward]

What do x-rays of his other feet look like there? If they are not the same, to me that would be telling.

[fivestrideline]

Other feet are clear/one piece there, as far as I can tell

[beowulf]

Not a vet, but that certainly looks like more than a shadow to me. In your shoes I would certainly be pursuing a second set of views.

[fivestrideline]

I reached out to my vet for a review, sent them my edited rads with circles on the areas of concern. I don’t expect to hear back until next week.

General non-professional consensus from a friend at the state vet school (apparently my rads got passed around ) is maybe a palmar process fracture. Could be benign or causing issues - interesting since it didn’t block out perceptibly when we were hunting a 3/5 lameness on that leg.

[hybriseris]

I’d assume it’s totally possible that, if it’s a fracture, it’s location means it could not really causing all that much pain or any at all. I think it’d just be good to get it confirmed and see if it’s something a farrier can shoe him to either heal or support.

Thanks for sharing with us, really interesting and I hope it all gets figured out and fixed if needed!

[No1]

If you had older X-rays, it would be easier to say if this was a new issue or just something the horse lives with. Since you don’t, blocking is the best tell and you’ve already done that.

As you are taking repeat X-rays to monitor palmar angle, you could make sure the vet also takes appropriately angled X-rays to monitor this while the horse is on stall rest. That way you get a trend of whether it appears to be healing or is a non-union. If your farrier puts a bar shoe on, you can be sure that area is stablized while the horse is one stall rest already.

You’re right, that solar view is no good. If the vet was going to leave the shoe on, they should have also taken 2 obliques. One to see each wing.

Good on the farrier for noticing and super weird that the vets who took the May and Oct didn’t at least mention it. Though, if the vet in Oct had access to the previous X-rays, maybe they thought you knew already? The March X-rays aren’t super clear and it could have very well been some sort of shadow.

Actually, in the May X-rays, it looks like the other wing may be the same, but that could very well be an artifact.

[fivestrideline]

Only the recent vet had access to previous X-rays, so maybe they thought it was a known issue. Not bringing it up at all though, isn’t what I personally would have done but that’s just me. To be fair, it was a new client appointment and supposed to just be an ultrasound and balance films for a rehab case.

I’m waiting to hear back from the vet, at which point I’ll decide if we are taking new films. I’m considering trying to line up farrier and vet to work together on the feet. But I’d like to know what we are dealing with currently, especially since we just put wedges on the fronts.

[Elliot12]

An MRI might give the answer.

[TBKite]

They can have a separate centre of mineralization in the lateral cartilage as an interesting variant on normal. There is not much bone reaction for a chronic fracture. Hoof rads are definitely not my area of expertise, though.