Lame - Exam for small animal lameness Flashcards
What are some important questions to ask in small animal lameness cases?
Medication
Duration of lameness
Onset
Progression
Continuous or intermittent
Effect of exercise/rest
Which limb
How does exercise/rest affect different types of lameness?
Soft tissue injury - gets worse with exercise
Arthritis - worse after rest, exercise helps loosen up
How do you do a small animal gait evaluation?
Evaluate gait at a walk, trot
Then go in circles
What should you look for in a gait evaluation?
Observe stride length, head nodding, scuffing nails
When does the head nod occur?
On the sound side
What are the lameness gradings?
0-10
0 - sound
2 - sound when walking, milk lameness when trotting
3 - mild lameness when walking
4 - obvious lameness when walking, places foot when standing
5-8 - degrees of severity
9 - places toe when standing, carries limb when trotting
10 - unable to bear
What do you palpate a standing animal for in an orthopaedic physical exam?
Asymmetry
Swelling - medial buttress
Muscle atrophy
Joint enlargement
Abnormal conformation
What acronym can you use to remember what to look out for in joints in a orthopaedic physical exam?
SPIRM
S - swelling
P - pain
I - instability
R - range of motion
M - manipulation
What should you not forget to look for in an orthopaedic exam?
Limbs - not just joints, could be a bone mass etc.
Neuro exam
What test can you do for a ruptured cranial cruciate ligament?
Cranial draw test
(tibial compression test)
What is a tibial compression test?
Tests cranial cruciate ligament by flexing the hock while keeping the stifle still
The tibial tuberosity displaces cranially if ligament ruptured
How can you test for patella luxation?
Stifle extended - then try and shift patella medially and laterally
What is the most common developmental orthopaedic condition in cats?
Patella luxation - laterally
What is a test for hip laxity in young dogs?
Ortolani test
Press femur down towards back which in dorsal recumbancy
Then abduct the femur - will click as hip reduced
adduct - click as hip reluxated
What is the pneumonic to remember differential diagnoses for bone conditions?
GIFT
Growth plates
Inflammatory/infectious/immune
Fractures
Tumours
What is the pneumonic to remember differential diagnoses for joint conditions?
DIM
Dislocation
Inflammation
Musculotendinous and ligamentous
What are the best diagnostic imaging methods to use in orthopaedics?
Radiography
CT
How do you identify joint effusions?
The fat pad in the stifle is squished - can see on radiography as soft tissue opacity in the joint
How can you tell there is a joint effusion in the carpus?
Loss of definition of the carpal bones cranially- cant feel bony prominances
How can you tell there is a joint effusion in the elbow?
Bulge between the olecranon and lateral epicondyle
How can you tell there is a joint effusion in the hock?
Palpable as bulge cranially and caudally
How can you tell there is a joint effusion in the stifle?
Bulges out either side of patella ligament
What joints are joint effusions not palpable in?
Shoulder and hip
What is the term for taking a sample of joint fluid?
Arthrocentesis
How do you take a sample of joint fluid?
Aseptic prep
Introduce needle and apply negative pressure
Release pressure before withdrawing needle from joint - will get blood in sample otherwise
What do you do with a joint fluid sample?
Smear and submit EDTA sample
Why should you do arthrocentesis?
To diagnose inflammatory joint disease
