Lame - Exam for small animal lameness

Question 1

What are some important questions to ask in small animal lameness cases?

Answer 1

Medication
Duration of lameness
Onset
Progression
Continuous or intermittent
Effect of exercise/rest
Which limb

Question 2

How does exercise/rest affect different types of lameness?

Answer 2

Soft tissue injury - gets worse with exercise
Arthritis - worse after rest, exercise helps loosen up

Question 3

How do you do a small animal gait evaluation?

Answer 3

Evaluate gait at a walk, trot
Then go in circles

Question 4

What should you look for in a gait evaluation?

Answer 4

Observe stride length, head nodding, scuffing nails

Question 5

When does the head nod occur?

Answer 5

On the sound side

Question 6

What are the lameness gradings?

Answer 6

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

Question 7

What do you palpate a standing animal for in an orthopaedic physical exam?

Answer 7

Asymmetry
Swelling - medial buttress
Muscle atrophy
Joint enlargement
Abnormal conformation

Question 8

What acronym can you use to remember what to look out for in joints in a orthopaedic physical exam?

Answer 8

SPIRM
S - swelling
P - pain
I - instability
R - range of motion
M - manipulation

Question 9

What should you not forget to look for in an orthopaedic exam?

Answer 9

Limbs - not just joints, could be a bone mass etc.
Neuro exam

Question 10

What test can you do for a ruptured cranial cruciate ligament?

Answer 10

Cranial draw test
(tibial compression test)

Question 11

What is a tibial compression test?

Answer 11

Tests cranial cruciate ligament by flexing the hock while keeping the stifle still
The tibial tuberosity displaces cranially if ligament ruptured

Question 12

How can you test for patella luxation?

Answer 12

Stifle extended - then try and shift patella medially and laterally

Question 13

What is the most common developmental orthopaedic condition in cats?

Answer 13

Patella luxation - laterally

Question 14

What is a test for hip laxity in young dogs?

Answer 14

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

Question 15

What is the pneumonic to remember differential diagnoses for bone conditions?

Answer 15

GIFT
Growth plates
Inflammatory/infectious/immune
Fractures
Tumours

Question 16

What is the pneumonic to remember differential diagnoses for joint conditions?

Answer 16

DIM
Dislocation
Inflammation
Musculotendinous and ligamentous

Question 17

What are the best diagnostic imaging methods to use in orthopaedics?

Answer 17

Radiography
CT

Question 18

How do you identify joint effusions?

Answer 18

The fat pad in the stifle is squished - can see on radiography as soft tissue opacity in the joint

Question 19

How can you tell there is a joint effusion in the carpus?

Answer 19

Loss of definition of the carpal bones cranially- cant feel bony prominances

Question 20

How can you tell there is a joint effusion in the elbow?

Answer 20

Bulge between the olecranon and lateral epicondyle

Question 21

How can you tell there is a joint effusion in the hock?

Answer 21

Palpable as bulge cranially and caudally

Question 22

How can you tell there is a joint effusion in the stifle?

Answer 22

Bulges out either side of patella ligament

Question 23

What joints are joint effusions not palpable in?

Answer 23

Shoulder and hip

Question 24

What is the term for taking a sample of joint fluid?

Answer 24

Arthrocentesis

Question 25

How do you take a sample of joint fluid?

Answer 25

Aseptic prep
Introduce needle and apply negative pressure
Release pressure before withdrawing needle from joint - will get blood in sample otherwise

Question 26

What do you do with a joint fluid sample?

Answer 26

Smear and submit EDTA sample

Question 27

Why should you do arthrocentesis?

Answer 27

To diagnose inflammatory joint disease