Targeted radiographic projections provide reliable quantification of proximal and distal canine femoral morphology in the absence of computed tomography.

Horizontal beam radiography reliably quantifies proximal femoral morphology and aLDFA, replacing CT when unavailable.

This prospective study evaluated the accuracy of three craniocaudal femoral radiographic techniques—extended limb, sitting position, and horizontal beam—compared to CT scans for quantifying proximal and distal femoral morphology in dogs. Twenty-five dogs (50 femora) weighing 14–45 kg with normal orthopedic examinations underwent all three radiographic views and CT imaging. Two investigators independently measured four angular parameters: anatomic lateral distal femoral angle (aLDFA), mechanical lateral distal femoral angle (mLDFA), anatomic lateral proximal femoral angle (aLPFA), and mechanical lateral proximal femoral angle (mLPFA). Statistical comparisons were made against CT as the reference standard, with interobserver reliability assessed via intraclass correlation coefficients (ICC). The horizontal beam technique demonstrated the highest accuracy for aLPFA, mLPFA, and aLDFA measurements, showing no significant difference from CT values. The extended limb view was most accurate for mLDFA. The sitting position was not superior for any measurement. All four parameters showed high interobserver agreement across all techniques (ICC > 0.8). These findings indicate that targeted radiographic projections can reliably replace CT for femoral morphology assessment when advanced imaging is unavailable. Specifically, the horizontal beam view is recommended for preoperative planning of total hip replacement and patellar luxation correction via aLDFA assessment, offering a cost-effective and accessible alternative to CT in clinical settings.

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