New Radiographic Guidelines for Equine Pre-Purchase Examinations

Since 1 April 2026, new radiographic guidelines issued by the Society for Equine Medicine (GPM) have come into force. These guidelines are expressly recommended for pre-purchase examinations of horses. Their aim is to facilitate the assessment of potential risks and to provide greater certainty when purchasing a horse.

The guidelines apply to clinically sound warmblood horses aged three years and older. They serve as a reference for veterinarians regarding the standardised acquisition and interpretation of radiographs as part of pre-purchase examinations and are intended to promote a consistent evaluation of radiographic findings.

Instead of the previous 18 standard views, 22 are now recommended. An additional projection of the fetlock joint has been included: the 0° projection of all four fetlock joints. Previously, a 90° projection was recommended. This change is intended to allow a more precise assessment of the fetlock joints with regard to potential pathologies such as bone cysts, fissures, and osteoarthritis.

According to the Radiography Commission, the clinical examination remains the most important basis for assessing a horse’s current health status. Radiographic examination should be regarded as a complementary diagnostic tool.

Furthermore, the GPM guidelines specify how radiographic findings should be documented:

• Catalogued radiographic findings associated with a risk of lameness, classified as “risk findings”
• Catalogued radiographic findings for which the associated risk cannot be reliably assessed
• Radiographic findings that deviate significantly from normal radiographic anatomy, do not represent anatomical variants, but are not included in the current radiographic guidelines

Findings not listed in the guidelines should be described in as much detail as possible but should not be diagnostically interpreted. In doing so, factors such as structure, contour, size, location, shape, and number should be taken into account.

Normal anatomical findings continue to be documented as “no significant findings”. Any unclear findings requiring further radiological investigation must be requested separately and are not part of the standard scope of a pre-purchase examination.

The DICOM format remains the required standard for image storage and transmission. It should be noted, that these guidelines apply only in Germany.

Sources: Society for Equine Medicine (GPM) (2026): GPM Radiographic Guidelines 2026. Frankfurt am Main. Available at: https://gpm-vet.de/images/GPM_Roentgen_Leitfaden_2026.pdf