How to perform an orthopaedic exam of the horse

Question 1

What should be done before exam?

Answer 1

Detailed clinical history - level of horse work, farriery, age, breed, involvement of physiotherapy + saddlers
*Establish owners concern + what outcome they want.
*Ask for when problem started, when it is seen and how it has manifested?
*Persistent/intermittent problem?
*Any meds/Tx

Question 2

What should be done first with the exam?

Answer 2

Observe horse at rest on flat area with horse stood flat observe from front, side + rear?

Question 3

What can be assessed from the side?

Answer 3

Overall balance of the horse, muscling + condition

Question 4

What is observed from the rear?

Answer 4

Hindlinb muscle symmetry

Question 5

What is observed from the front?

Answer 5

Conformation of the forelimb
-angular limb deformities
-rotational abnormalities

Question 6

Where does palpation of the horse begin?

Answer 6

At the neck - palpate both sides starting cranially, identify transverse process of vertebra and work backwards
*Food bribe used to assess motion of neck

Question 7

How is the foot examination carried out?

Answer 7

*Start by palpating coronary band - for damage trauma, inflammation
*Check for abnormal rings as sings of laminitis
*Check pulses at fetlock - increased pulse = inflammation
*Palpate heel bulbs for abnormalities - clean foot out + check horn for softness
*Lastly use hoof testers to check sole + monitor response

Question 8

What should be done with the fetlock?

Answer 8

*Check fetlock ligaments
-digital flexor tendon
-palmar annular ligament
-suspensory ligament (lateral + medial)
-Check deep digital flexor tendon + Superficial flexor tendon + distal sesamoidean ligaments on palmar aspect

Question 9

What should be checked with metacarpus?

Answer 9

Check for swelling if any history of trauma
-race horses with shin splints

Question 10

What is checked with the carpus?

Answer 10

*start with limb weightbearing
*check extensor tendons palpating over front of limb
*check carpus for effusions - might be easier with limb up
*joint pain checked when limb flexed + extended

Question 11

What is checked in the elbow?

Answer 11

*Locate lateral collateral ligament
-swelling behind / in front of ligament = effusion

Question 12

Why is palpation of olecranon important?

Answer 12

trauma to area may result in fracture + loss of stay apparatus

Question 13

How is shoulder palpitation carried out?

Answer 13

*Identify point of shoulder + greater tubercles
palpate spine and muscles of scapula

Question 14

What can trauma to the deltoid tuberosidty lead to?

Answer 14

Infection of the shoulder joint

Question 15

How would you assess the back?

Answer 15

Start at withers - check for pain + swelling
*work from thoracic to lumbar region

Question 16

When would trauma of the withers occur?

Answer 16

If horse falls over backwards

Question 17

What is palpated of the pelvis?

Answer 17

Tuber sacrale
Wing of ilium
Tuber coxae
*Gluteals, biceps femoris + hamstrings assessed for pain + swelling

Question 18

How is the tail tone assessed?

Answer 18

Raising it and moving to each side

Question 19

How is stifle assessed?

Answer 19

*Stand in front holding tail
*locate tibial tuberosity, dorsally to middle patellar ligament - either side of this is the femoropatellar joint.
*palpate behind medial patellar ligament for effusion of medial femorotibial joint

Question 20

What is checked with the hock?

Answer 20

Medial + lateral malleolus
*cranial tibial tendon
+superficial digital flexor tendon
*gastrocnemius
*Palpate with horse weight bearing + limb up

Question 21

Once static assessment is done what should be done

Answer 21

1. Assess horse walking - 4 beat gait - check for lameness + turning
   -stride length
   2.Trotting - 2 beat gait - symmetry of hindquarters assessed - Dropping of affected side = lame
   *Lameness of forelimb = head moving up or away from affected limb