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Caudal foot placement superior to toe elevation for navicular palmaroproximal-palmarodistal-oblique image quality

Peeters, Manon W.J.; Thursby, Jasmine J.; Watson, Hannah E.; Berner, Dagmar


Manon W.J. Peeters

Jasmine J. Thursby

Hannah E. Watson

Dagmar Berner


Background: Palmaroproximal-palmarodistal oblique (PaPr-PaDiO) radiographs are regularly obtained for full evaluation of the navicular bone (NB). Despite their routine use, different acquisition techniques are described.
Objectives: Determining the best combination of foot placement and beam angle for obtaining PaPr-PaDiO views.
Study design: Prospective experimental study
Methods: Twenty-six randomly chosen disarticulated forelimbs were placed in six different positions using a leg press to mimic the weight bearing position. In each position, navicular skyline images were obtained with eight different beam angles resulting in a total of 1248 radiographs.
Results: Diagnostic quality and compacta-spongiosa demarcation was graded higher for feet positioned caudally and angles between 40 and 50 degree. Elevation of the toe decreases significantly the NB palmar border angle (elevated mean: 40.66, SD: 4.46, non-elevated mean: 42.06, SD: 4.70) (p < 0.01), but seems to have no obvious positive influence on radiographs. In limbs with a steeper angle of the palmar border, a steeper primary beam angle resulted in better diagnostic quality and compacta-spongiosa demarcation.
Main limitations: Using disarticulated legs could only mimic positions but by using a press, weight bearing positions were replicated as closely as possible.
Conclusions: Caudal foot placement seems to improve image quality of the navicular PaPr-PaDiO view. The wildly used standard beam angle of 45 degree appears to be the favourable angle for acquisition with a variation range of ± 5 degree. Elevation of the toe, standard in most commercial available navicular skyline cassette holders, does not seem to improve or reduce the obtained image quality.


Peeters, M. W., Thursby, J. J., Watson, H. E., & Berner, D. (2022). Caudal foot placement superior to toe elevation for navicular palmaroproximal-palmarodistal-oblique image quality. Equine Veterinary Journal,

Journal Article Type Article
Acceptance Date Jan 17, 2022
Publication Date Jan 29, 2022
Deposit Date Mar 29, 2021
Publicly Available Date Feb 15, 2022
Print ISSN 0425-1644
Publisher Wiley
Peer Reviewed Not Peer Reviewed
Public URL


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