This is a companion article to The Diagnosis of Lameness in Horses which should be read first if the cause and location of the lameness is not known.

Ever wonder what the vet is looking for when he looks at those radiographs? By putting together the clinical findings with the radiographic changes it is often possible to come to the diagnosis, treatment, and prognosis for the lameness. In the accurate diagnosis of lameness abnormal radiographic findings must be evaluated in light of:

• Clinical findings
• Radiographic findings
• The severity of the radiographic changes
• The established relation of the specific radiographic changes with causing lameness

This article discusses the accurate diagnosis of lameness using radiographs and provides links to specific diseases diagnosed radiographically.

Contrary to what most horse owners believe radiographic findings do not correlate well with pain or lameness. If you take survey radiographs of almost any sound horse you can find some abnormal radiographic findings somewhere. Conversely a normal set of radiographs does not rule out the location as a source of lameness. Often lameness is caused by soft tissues not well visualized radiographically and even early osteoarthritis may be present before radiographic lesions are evident.

This leads us to two important points:

1. The examination and localization of where the pain comes before radiography and should direct what areas are radiographed and subsequently treated.
2. Finding radiographic evidence of disease should be followed by further attempts to support the diagnosis. This support can come in the form of careful evaluation of the significance of the lesions, further diagnostic testing, or treatment to see if the disease responds as expected.

For more on the proper localization of lameness in the horses see The Diagnosis of Lameness in Horses.