BY ZOË JOOSTENS DVM MSC EBVS® DIPECVDI-LA®
PHOTOGRAPHY: COURTESY EQUITOM

Over the past two decades, equine veterinary medicine has undergone a quiet revolution –
one powered by remarkable progress in diagnostic imaging.

Once limited to basic radiographs and ultrasound, veterinarians today have access to an expanded toolkit of advanced modalities that reveal clearer, more detailed, and more dynamic information about the equine body than ever before. These technologies not only improve diagnostic accuracy but also guide more targeted treatment plans and help shorten recovery times. Below is an overview of the major imaging modalities used in modern equine practice, how they work, and when they are most beneficial. Radiography: The foundation of equine imaging Radiography remains the most widely used imaging modality in horses, both in a hospital setting and at the stable. Recent developments – especially in digital radiography (DR) and advanced image filtering – have greatly improved image clarity, even in regions previously difficult to capture with portable systems, such as the neck and back. How it works: X-rays generated by an x-ray tube pass through the horse’s body and are captured on a detector plate. In DR systems, the image is converted instantly into a digital file. Dense structures - such as bone or metal - absorb more radiation and appear radiopaque (white) on the image. Soft tissues and fluid allow more x-rays to pass through, rendering them in shades of grey. Air does not attenuate x-rays and therefore appears black, often described as radiolucent. Uses and indications: Radiography is the first line imaging choice for:
• detection of fractures, bone chips, and osteoarthritis;
• evaluating hoof balance, laminitis, and navicular changes;
• assessing dental and sinus structures;
• screening tool during pre-purchase examinations.
Ultrasound: Visualizing soft tissue in real time Ultrasound is a mainstay for evaluating soft-tissue structures, offering excellent real-time image resolution. Improvements in probe technology and imaging software have made it a far more powerful diagnostic tool than it was even a decade ago. However, ultrasound remains more operator-dependent than radiography, and in both modalities, good technique is essential. How it works: High-frequency sound waves emitted by a transducer bounce off tissues and return as echoes, which appear as white dots on the screen. These dots form a dynamic, real-time image. Dense structures such as tendons generate many echoes and appear white or hyperechoic, while free fluid does not reflect sound waves and may even enhance them, appearing black and described as anechoic or hypoechoic.
Uses and indications:
• tendon and ligament injuries
• joint evaluation, including joint capsule, ligaments,
cartilage and menisci
• thoracic and abdominal imaging (e.g., lungs, intestines...

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