Re: New Hoof Radiograph


Lavinia Fiscaletti
 

Hi Karen,

I've added a mark-up to King's album:

https://ecir.groups.io/g/CaseHistory/album?id=1402&p=pcreated,,,20,2,0,0

Was he standing squarely on the foot when that view was taken? It doesn't appear so.

Green are the trim lines - way too much toe and excess hoof capsule height. Whether or not the heels can be lowered further is going to depend in part on what the rest of the bony column alignment is when he is actually weighting the leg. Initially, I wouldn't lower them more than in the mark-up. Yellow lines are evidence of sinking - which is not new. It was present on the last xrays as well. Pink area shows fuzziness on the dorsal surface of P2, which is consistent with ringbone formation.

There is a considerable amount of erosion of the tip of the coffin bone (inside purple circle). There are also several dark shadows that could be gas pockets, abscess collections and/or infection so otseomyelitis is a concern. When the toe is taken back, it is likely there will be some kind of exudate inside, as well as possible open gaps. The overall texture may be punky.

I've asked Dr. Kellon to please comment as soon as she has a moment.
--
Lavinia and George Too

Dante, Nappi and George over the Bridge

Jan 05, RI

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