Radiography: carpus and forefoot

• A high definition film-screen combination is required.
• A grid is not required.
• kV should not exceed about 50.
• Soft tissues should be included.
• A radiograph including both limbs is useful for comparison.
• General anesthesia or sedation may be required.
• The film should be correctly exposed and developed, and free from movement blur and artifact.
• The anatomical marker must be clearly visible, along with the patient's identification, the date, and the name of the hospital or practice.
  Print off the Owner factsheet on Xray and Ultrasound to give to your clients

Uses

• Fracture Limb fracture.
• Dislocation.
• Neoplasia: bony, or soft tissue invading bone.
• Carpal valgus/varus but full length radius and ulna views including the carpus may be preferable.
• These development abnormalities are common in giant rabbits.
• Foreign bodies.
• Arthritis.
• Paronychia.

Advantages

• Non-invasive.
• Straightforward.

Time required

Preparation

• Dependent upon the method of chemical restraint (GA or sedation).

Procedure

• 10 to 15 min, or longer, dependent upon skill of radiographer.

Decision taking

Criteria for choosing test

Is the examination appropriate?

• Can you make the diagnosis without it?
• Can it tell you what you want to know?
• Will your management be affected by the radiological findings?

Choosing the right projections

• Lateral:
  • Standard projection .
  • Important for the carpus, when looking for fractures or dislocation.
  • Shows soft tissue swelling/joint effusion.
  • Vital for localizing radio-opaque foreign bodies in the foot.
  • Can show fractures and displacement of metacarpals and phalanges, but obliques usually more useful.
• Dorsopalmar:
  • Standard projection .
  • More useful than the lateral in the foot, as metacarpals and phalanges are not overlying each other.
  • Important in the carpus for fractures and dislocations.
  • Shows joint effusion/soft tissue swelling.
  • Vital to have two views at right angles to localize radio-opaque foreign bodies in the foot.
• Dorsolateral-palmaromedial oblique/dorsomedial-palmarolateral oblique:
  • Supplementary views.
  • Can be important in the carpus, for giving full information on fractures and dislocations.
  • Can be very useful in the foot for showing metacarpals and phalanges in a different plane from the dorsopalmar, but without as much overlapping as in the lateral.
• Stressed views of the carpus - forced abduction or adduction, forced flexion or extension:
  • Supplementary views.
  • Useful for confirming or assessing extent of carpal instability.