Considering the common scenario of a horse presenting with a medial-lateral imbalance.
When we consider the common scenario of a horse presenting with a medial-lateral imbalance, we can assume that the hoof capsule will be in motion asymmetrically around the distal phalanx due to the inappropriate orthopaedic balance of that limb. In the above scenario, the consequence of an inappropriate asymmetrical hoof capsule will be that the sensitive lamina interface is placed under considerable strain. This means the misalignment of the internal structures of the individual foot, thus eliciting a neurological response to pain. The external observation of an asymmetrical hoof capsule would reveal the heels of the hoof capsule being closer to the frog on one side than the other. The presentation of the hoof capsule being closer to one side of the frog than the other normally identifies the loading stance of the horse and thus allows us to guide the hoof's side that needs to be lowered during the trimming process. The inappropriate loading stance that instigated the rotation of the hoof capsule around the distal phalanx also results in the white line having small lines rotating to the high side of the hoof capsule.
There are other pathological changes to the hoof structures that we can use to identify the medial-lateral imbalance of a foot. These include excess hoof growth on the high side, thickening of the hoof wall on the high side in relation to the low side, the sole being in alignment with the hoof wall on the high side and lower on the low side, the external bar of the foot being straighter on the high side and curved or laying over on the low side and even appearing to be shorter in length on the low side. These are all basic pathological markers of a medial-lateral hoof imbalance.