
05/03/2025
X-rays or CT?
Imagine your horse has a neck problem, your regular vet recommends x-rays but another vet says x-rays of the neck don't tell us much and you should do a CT instead. What should you do? What is the difference?
X-rays show us the "outside" of the vertebrae. It is like looking at a tree trunk we can only see the bark and the shape of the outside of the tree. With radiographs (x-rays) we can see if there is a lot of arthritis in the joints and we can see if there is a mis-alignment of the vertebrae or ECVM. We cannot see the "inside" of the spine, the part where the spinal cord lives. We also cannot get a clear view of the IVF or bony tunnel in between the vertebrae that the nerves have to travel through to go out to the body. There could be a problem that will not show up on x-rays.
CT or computed tomography shows us both the outside and the inside, it is like looking at a tree after it has been cut, you can see the heart of the tree and all the growth rings. CT can give us important information about the spinal canal and that bony tunnel. CT is a good choice to look for spinal cord compression or a "pinched" nerve. A CT gives us a lot more information than an x-ray.
There are also big differences in the procedures. X-rays can be done in your barn, require little to no sedation and are less expensive. A CT scan for the low neck requires general anesthesia, must be done at the clinic and is more expensive.
Which is the best choice? There is no right answer for every situation. As a vet, I love getting as much information as possible so we can make the best treatment plan. But the higher cost and the risk of general anesthesia with a CT may mean that x-rays are the better choice. Talk it over with your vet. Ask what they are looking with the imaging and how the results would change the treatment plan or how the results would change your goals for your horse. Ask questions until you understand and are happy with your choice.