SA Lameness and Investigation of Orthopaedic Diseases

Question 1

List three things that you should observe in the stance of a lame dog

Answer 1

Symmetry
Weight bearing
Angular deformity

Question 2

How would you grade lameness in small animals?

Answer 2

0-10
0: Sound
1: Occasionally shifts weight
2: Mild lameness at slow trot, none whilst walking
3: Mild lameness whilst walking
4: Obvious lameness whilst walking, places foot when standing
5-8: Degrees of severity
9: Places toe when standing, carries limb when trotting
10: Unable to weight bear

Question 3

List 5 things you may observe when palpating a
lame standing animal

Answer 3

Asymmetry
Swelling
Muscle atrophy
Joint enlargement
Abnormal conformation

Question 4

What is the acronym for things you should look for on an orthopaedic physical examination? What does it stand for?

Answer 4

SPIRM
Swelling, joint effusion
Pain
Instability
Range of motion
Manipulation

Question 5

What does the cranial draw test show?

Answer 5

The integrity of the cranial cruciate ligament

Question 6

Describe how you would perform a cranial draw test

Answer 6

Lateral recumbency
Hold fermur and tibia and try to move tibia cranially with respect to the femur
Repeat test with stifl at different angles or flexion/extension

Question 7

What does the tibial compression test show?

Answer 7

Cranial cruciate liagment integrity

Question 8

Describe how you would perform the tibial compression test

Answer 8

Hand over distal fermur, first finger on the tibial tuberosity, other hand on foot
Keep stifle still whilst flexing the hock
Tibial tuberosity displaces cranially if ligament ruptured

Question 9

Describe how you would test for patella luxation

Answer 9

Stifle extended - quadriceps relaxed
Try and shift patella medially and laterally

Question 10

What is the ortolani test used to show?

Answer 10

Hip laxity

Question 11

Describe how you would perform the ortolani test

Answer 11

Dorsal recumbency
Subluxate hips by pressing towards back
Abduct femurs
Adduct hips

Question 12

What is the acronym for the differential diagnoses of bone pathology and what does it stand for?

Answer 12

GIFT
Growth plates
Inflammatory/infectious/immune
Fractures
Tumours

Question 13

What is the acronym for the differential diagnoses of joint pathology and what does it stand for?

Answer 13

DIM
Dislocation
Inflammation
Musculotendinous and ligamentous

Question 14

What are CT scans useful for in orthopedic examinations of lame dogs?

Answer 14

Useful for identifying minimally displaced fractures

Question 15

What is MRI useful for in orthopaedic examinations of lame dogs?

Answer 15

Useful for soft tissue architecture
Less useful for bone
Very useful for neurology/nerve root tumours

Question 16

When palpating for joint effusions, how would a carpus feel with a joint effusion?

Answer 16

Loss of definition of carpal bones cranially

Question 17

When palpating for joint effusions, how would the elbow feel with a joint effusion?

Answer 17

Bulge between olecranon and the lateral epicondyle

Question 18

When palpating for joint effusions, how would the shoulder and hip feel with a joint effusion?

Answer 18

Effusions are not palpable

Question 19

When palpating for joint effusions, how would a hock feel with a joint effusion?

Answer 19

Palpable as a bulge cranially and caudally

Question 20

When palpating for joint effusions, how would a stifle feel with a joint effusion?

Answer 20

Bulges out either side of the patella ligament

Question 21

Describe how you would perform arthrocentesis

Answer 21

Clip and aseptic preparation
Introduce needle and apply negative pressure with needle held still
Release pressure before withdrawing needle from joint
Make smear and submit EDTA sample