FLORIAN GEBUREK, DrMedVet, ANNA K. RÖTTING, DrMedVet, PhD, Diplomate ACVS & ECVS , and PETER M. STADLER, Prof DrMedVet Veterinary Surgery April 2009 38 3 310-317 Objective—To assess agreement between ultrasonography (transcutaneous and transrectal) and standing radiography in horses with fractures in the pelvic region and disorders of the coxofemoral joint. Study Design—Case series. Animals—Warmblood horses (n=23) and 2 ponies. Methods—Medical records (1999–2008) of equids with pelvic or coxofemoral disorders that had pelvic radiography and ultrasonography were retrieved and results of both techniques compared. Results—Radiography and ultrasonography each identified equal numbers of fractures of the tuber coxa (n=4), ilial shaft (2), ischium (3), femoral neck (2), and osteoarthritis/osis of the coxofemoral joint (6). Fractures of the ilial wing (4) were only identified by ultrasonography not by standing radiography. Of 9 acetabular fractures, 3 were identified on radiographs only, 5 were identified with both modalities. One pubic fracture was identified using ultrasonography and radiography. One acetabular and 1 pubic fracture were only diagnosed on necropsy. Conclusions—We found reasonable agreement (73%; 24/33) between ultrasonography and standing radiography for diagnosis of pelvic–femoral disorders. Ultrasonography was more useful for ilial wing fractures and radiography for acetabular fractures. Clinical Relevance—Ultrasonography is a rapid, safe imaging technique for detecting disorders of the pelvic region with a high diagnostic yield and is a preferred initial approach in horses with severe hindlimb lameness.