Page 75 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

50 CHAPTER 1

VetBooks.ir All limbs should be palpated and manipulated in a Diagnosis
The clinical history and findings are diagnostic and
non-weight-bearing position for evidence of joint
instability (mainly congenital forms), growth plate
confirmed by radiography. Dorsopalmar/plantar and
swelling and heat/pain/swelling suggestive of exter- the specific problem and subsequent management are
nal trauma. A full lameness examination is essential, lateromedial projections are taken using long plates,
including assessing foot placement. The presence of which allow the long bones proximal and distal to
lameness is significant because foals with ALDs are the deformity to be radiographed (Figs. 1.90, 1.91).
not normally lame. Traumatically-induced cases usu- It is useful to assess objectively the angulation of the
ally present acutely with lameness and varying insta- deformity by drawing a line joining proximal and
bility. Some bony swelling associated with the growth distal points in the middle of the long bones, both
plate is quite common in longer standing cases. above and below the affected joint, and measuring
the angle of deviation from the vertical: a normal
Differential diagnosis range of angulation of the carpus and tarsus can be
Concurrent flexural deformities and/or OCD; trau- expected to be from <5° through to mild/ moderate
matic injuries. (5–10°) and severe angulation (>10°) (Fig. 1.92).

1.90 1.91 1.92

Fig. 1.90 Dorsopalmar Fig. 1.91 Severe varus angular Fig. 1.92 Dorsopalmar radiograph
radiograph of the right forelimb limb deformity of the fetlock joint. of a foal with moderately severe carpal
of a foal with severe carpal Note the wedging of the epiphysis valgus. Lines drawn between the mid
valgus deformity showing the and severe tipping of the physis in points of the long bones proximal and
degree of angulation, wedging the distal third metacarpus. distal to the carpus intersect at the level
of the epiphysis, ectasia of the of the carpal bones and the degree of
physis and metaphyseal flaring deformity is measured as 13.9°.
often noted in such cases.