Why Hip and Elbow X-Rays Are Only One Part of the Picture

• As of 2026, none of the dogs that we have bred have been diagnosed with either Hip or Elbow Dysplasia

Hip and elbow dysplasia are genuine concerns for anyone buying a puppy. We take those concerns seriously, and we understand why many breeders and buyers place significant weight on x-ray results. Screening tools matter. But they are often misunderstood. Hip and elbow x-rays are not definitive tests, and they are not guarantees of healthy joints or lifelong soundness.

To understand why, it’s important to look beyond the score itself and understand what x-rays can show—and just as importantly, what they cannot.

Hip and Elbow Dysplasia Are Not Simple Genetic Diseases

Unlike conditions that can be identified with a single DNA test, hip dysplasia (HD) and elbow dysplasia (ED) are polygenic and multifactorial. This is not a controversial position; it is well established across decades of veterinary and genetic research.

In simple terms, this means:

• There is no single “HD gene” or “ED gene”

• Multiple interacting genes influence risk

• Environmental and developmental factors play a decisive role in whether that risk is ever realised

  
  

As summarized in recent research, genetics create predisposition, not destiny. Environment determines expression.

Factors influencing joint outcomes include:

• Multiple genes (most of which cannot currently be tested)

• Inbreeding and loss of genetic diversity

• The breed’s genetic foundation

• Body weight and growth rate

• Nutrition during puppyhood

• Muscle development and coordination

• Exercise intensity and surface during growth

• Early stress loading and micro-trauma to immature joints

Large population studies consistently estimate heritability for HD and ED in the range of 20–40%, depending on breed and population. This means that more than half of the risk is non-genetic. Any approach that treats radiographic appearance as a standalone predictor ignores the majority of contributing factors.

What Dysplasia Really Is

Dysplasia is best understood as a developmental disorder, not a congenital defect.

Decades of veterinary research consistently show:

• Dogs are not born with dysplasia

• It develops during growth

• Joint looseness (laxity) comes before arthritis

• Arthritic changes are a secondary outcome, not the disease itself

  
  

This distinction is critical. Dysplasia is not a single event or a simple diagnosis—it is a process that unfolds over time, shaped by multiple interacting factors.

Hip and elbow dysplasia are not conditions confined to the German Shepherd. They are seen across a wide range of breeds, and in some cases at significantly higher rates. For example, breeds such as the English Bulldog consistently demonstrate a higher prevalence of joint abnormalities, underscoring that dysplasia is a broader canine health issue rather than a problem unique to any single breed.

What an X-Ray Really Shows

An x-ray is a snapshot, taken on a single day, under specific conditions. It does not tell us:

• What genes a dog carries

• What genes it will pass on

• How its joints will function over time

• Whether the dog will ever experience pain or limitation

Radiographs measure structure—not function, not comfort, and not quality of life. Dogs with excellent scores can and do produce offspring with joint issues. Conversely, many dogs with borderline or unscored hips live long, active, pain-free lives.

This is why treating x-ray results as a binary pass/fail test oversimplifies a complex biological reality.

Why A3 or “Borderline” Scores Are Often Misunderstood

A borderline hip rating (such as A3) does not indicate:

• A clinically sick dog

• A guaranteed producer of dysplasia

• A lack of functional ability

It reflects a structural evaluation at a fixed moment in time, without context for:

• Muscle strength and support

• Growth history

• Weight at maturity

• Environmental management

• Functional longevity

Many dogs with borderline scores:

• Never show pain

• Never develop lameness

• Excel in work, sport, or active family life

When policy or breeder language frames these dogs as “problematic,” the consequence is often public misunderstanding, not improved health. Labels matter. For buyers unfamiliar with nuance, exclusion from breeding is frequently interpreted as illness, weakness, or defect—none of which are medically justified.

Responsible breeding requires precision in both selection and communication.

Why Positioning, Scoring, Age, and Anaesthesia Matter

Hip and elbow scoring also has inherent technical limitations:

Positioning:

Small differences in leg placement, pelvic alignment, or muscle tension can meaningfully change how a joint appears on film.

Scoring:

Radiographs are interpreted by trained humans. Judgment is involved, and small variations between scorers are not unusual.

Age:

Most dogs are evaluated around 12 months, yet joints continue to mature. Some changes relevant to long-term soundness are not fully apparent until closer to two years of age.

Anaesthesia:

Sedation or anaesthesia is required for proper positioning. While generally safe, it is not entirely risk-free, which is another reason x-rays should be used thoughtfully rather than reflexively.

Our Non-Negotiable Line: We Never Breed from Diagnosed Dysplasia

We do not breed from dogs diagnosed with hip or elbow dysplasia. That is a clear and firm boundary.

We also wait until dogs are over 2 Years of age before making breeding decisions. By this stage, most dysplasia that will become clinically relevant has declared itself. This allows us to assess not just what a joint looks like on film, but how the dog actually:

• Moves

• Functions

• Carries weight

• Lives day to day

This approach prioritises real-world soundness over static imaging.

How Inbreeding and Extreme Conformation Affect Joints

Joint health is shaped not only by genetics, but by how dogs are bred.

Inbreeding increases the likelihood that hidden risk factors will combine in offspring. Even outwardly healthy parents can carry the same predispositions.

Breeding for extreme conformation—excessive angulation, overly heavy builds, exaggerated proportions—alters how forces travel through joints, increasing long-term stress and wear.

Both practices reduce genetic diversity and concentrate structural risk, making joint problems more likely regardless of x-ray scores.

Closed Gene Pools and Context Matters

In closed, Kennel Club–registered gene pools, genetic diversity naturally declines over generations. In that context, hip and elbow scoring can play a useful role as a risk-management tool, and we do use it as one component of decision-making where options are already limited.

However, tools must be matched to populations.

In our outcrossed lines, genetic diversity is significantly higher. Risk factors are less concentrated and long-term joint health is influenced more by:

• Structural moderation

• Balance

• Muscle development

• Growth management

• Longevity and function

In these populations, rigid reliance on scores alone is neither necessary nor scientifically justified.

Why “Good Scores” Haven’t Solved the Problem

Hip and elbow scoring has been used for decades. Dysplasia has not disappeared. Dogs with excellent scores still sometimes produce affected offspring.

This tells us something important: screening alone does not address root causes.

Without addressing genetic diversity, inbreeding, structural exaggeration, growth rate, nutrition, and environment, repeating the same selection criteria will not produce different results. Scoring can identify risk—but it cannot resolve complexity on its own.

Prevention Is Active, Not Passive

One of the most overlooked insights in modern research is this: more than half of dysplasia risk is modifiable.

Effective prevention includes:

• Controlled, age-appropriate exercise

• Deliberate muscle development

• Balanced calcium-to-energy nutrition

• Weight discipline during growth

• Avoidance of repetitive impact on immature joints

• Thoughtful footing and surface exposure

This reframes dysplasia not as an inevitable genetic failure, but as a developmentally influenced outcome.

Our Holistic Approach

We focus on outcomes, not optics. Our breeding and puppy-raising decisions prioritise:

• Functional movement and balance

• Lean, healthy body condition

• Moderation in structure

• Thoughtful growth management

• Preservation of genetic diversity

• Selection for dogs who remain active and comfortable as adults

X-rays remain a useful piece of information—but they are not the sole determinant of health, quality of life, or breeding value.

Managing Risk Realistically

No system can eliminate risk entirely. Our goal is not perfection; it is responsible risk management, informed by science rather than simplification.

That means combining:

• Thoughtful breeding decisions

• Sensible puppy raising

• Long-term observation

• Honest communication

Our Commitment to Puppy Buyers

We are open, transparent and realistic. Our aim is to produce dogs who:

• Move well

• Stay active and comfortable

• Live long, functional lives

• Thrive as companions, workers, or family members

We believe real health comes from sound structure, sensible management and genetic diversity—not from chasing a single number on a piece of film.

We’re always happy to discuss joint health, diet, exercise, and puppy development, because what happens after your puppy goes home matters just as much as any screening done beforehand.

Our focus isn’t on chasing perfect x-ray scores—it’s on raising dogs who are healthy, active and resilient for life.

Key Scientific References

• Mäki et al., 2000 – Genetic analysis of hip dysplasia in German Shepherd Dogs

• Smith et al., 1997 – Effects of restricted feeding on hip dysplasia development

• Ginja et al., 2010 / 2015 – Canine hip dysplasia: review and meta-analysis

• Malm et al., 2013 – Heritability of HD and ED in working breeds

• Oberbauer et al., 2017 – Genomics of orthopedic disease in dogs

• Wayosi et al., 2025 – The Complexity of Hip Dysplasia in Dogs

  
  

Dawn & Phil 🐾