Flashcards in Generic Lameness Exam Deck (34)
What is the definition of lameness?
A clinical sign
- A manifestation of a functional/ structural disorder in one or more limbs that results in a gait abnormality
What is lameness caused by?
- Mechanical defect
- Neurological defect
What are the objectives of a lameness exam? To determine what 6 things...
- Whether the animal the lame
- Which limb(s) are involved
- Site(s) of the problem
- Specific cause
- Appropriate treatment
- Prognosis for recovery
What are the 7 steps of a lameness exam?
1. History, signalment, animal purpose
2. Inspection at rest
3. Palpation of Musculoskeletal system
4. Observation in motion
5. Manipulations and flexion tests
6. Diagnostic anaesthesia
7. Diagnostic imaging
Where is most lameness only visible?
When the animal is trotting
What are the 5 different classifications of lameness?
1. Supporting limb lameness
2. Swinging limb lameness
3. Mixed lameness
4. Primary/ baseline lameness
5. Compensatory lameness
What is Supporting limb lameness?
Evident when the animal is weight bearing in the stride
What is Swinging limb lameness?
Evident when the limb is in motion (swing phase)
- cause of lameness is generally upper limb or axial skeleton
What is mixed lameness?
A combination of both supporting and swinging limb lameness
What is Primary/ baseline lameness?
Lameness that is present before any flexion tests or manipulations
What is Compensatory lameness?
Where pain in one limb causes uneven weight distribution on another limb
- may cause this limb to become lame
What should you ask in the history of a lame animal?
- Duration of lameness
- Has the animal been rested or exercised since the onset? (got better or worse?)
- How severe was the lameness when first observed?
- Is the lameness improving, stable or worsening
- Was the cause of lameness observed?
- Does the horse warm out of the lameness?
- Any treatment given?
- When was the horse trimmed or shod last?
- Any previous injuries?
Do you do a physical exam when presented with a lame animal?
- But is recommended
- The entire musculoskeletal system should be thoroughly examined
What should you do when doing a visual exam at rest?
- Assess body and limb configuration
- Alter postures and weight shifting
- Observe each muscle group for symmetry
- Observe feet for abnormalities
- Assess foot from palmar/plantar aspect
- Observe whether the coronary band is straight and parallel to the ground
- Observe whether contralateral feet are the same size and shape
- Examine the solar surface of the foot
- Assess the shoe placement and the type of shoe
What may abnormal conformation predispose animals to?
Describe the palpation for lameness...
Use a systematic approach and stick to it
- Generally proximal to distal
- Palpate: muscles, tendons, ligaments, joint pouches, tendon sheaths, bursas and bones
- Feel for increased digital pulse and heat in the hoof
- Heat, swelling and pain cardinal signs can be picked up on palpation
What is the goal of a visual exam at exercise?
To identify limb(s) involved and the degree of lameness and/or incoordination
How do you observe horses for lameness when exercising?
- Walk them in a straight line
- Run them in a straight line
- Lunge in circles in both directions
What do you look for in visualexams of lame horses?
- Head nodding
- Gait asymmetry
- Changes in height of foot arc
- Length of stride
- Degree of fetlock extension
- Foot placement
- Action of shoulder musculature
- Symmetry in gluteal rise and pelvis movement
What does head nodding tell you about lameness?
Animal will drop their head on the sound limb and pick it up on lame limb
- this unloads the sorelimb
What does the degree of fetlock extension tell you about a lame horse?
The fetlock drops less in lame limbs and won't sink as much
What does hip rise tell you about lameness?
The hip of a lame limb shows a "flick up" when the foot of the lame limb bears weight
Describe the AAEP lameness grading system...
0 = sound
1 = lameness hard to observe and not consistently apparent regardless of circumstances
2 = lameness difficult to observe at walk or trotting in a straight line, consistently apparent under certain circumstances
3 = Consistently observable at trot always
4 = Marked lameness with obvious nodding, hitching or shortened stride
5 = Minimal weight bearing in motion and/or at rest
What are the three reasons for the use of provocative tests...?
- To demonstrate occult lameness in a horse that appears to be sound during initial evaluation
- To exacerbate mild lameness
- To aid in localisation of lameness
What are the types of provocative tests used in horses?
- Digital compression
- Hoof tester exam
- Knife and wedge tests
Describe the flexion provocative test...
- Joints are held flexed for 30s - 1 min
- Then the horse is trotted
Positive if horse appears lame, after it appeared sound on baseline or the horse appears lamer than baseline
Can be false positive or false negative
Describe the digital compression provocative test...
Apply pressure over a tendon swelling or splint etc. for 30-60s
- Response assessed based on reaction of the animal to palpation and on increase in lameness
Describe hoof tester provocative exam..
Use hoof testers to find areas of pain in the foot
What is diagnostic analgesia used for?
To help localise the anatomical area causing lameness
- Perineural (next to nerve)
- Intrasynovial (joints, tendon sheaths and bursas)
Start distal, then move proximal until lameness disappears/ decreases markedly