Page 146 - Adams and Stashak's Lameness in Horses, 7th Edition

112 Chapter 2

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Figure 2.95. Test to stress the medial collateral ligaments of the ligament of the femorotibial joint. The examiner’s shoulder can be
hock and stifle. Alternatively, one hand can be placed on the medial placed over the middle of the tibia and both hands on the distal
aspect of the distal tibia to selectively stress the medial collateral metatarsus to selectively stress the medial aspect of the hock.

FEMUR HIP
The muscles surrounding the femur are primarily The hip should be examined for asymmetry, swelling,
examined for swelling and/or atrophy. The femoral artery and atrophy of associated muscle groups. With hip
should be palpated for the quality of pulsations on the problems, swelling over the coxofemoral joint may be
medial side of the thigh in the groove between the sarto­ visually apparent, and pain can often be elicited with
rius muscle cranially and the pectineus muscle caudally. If deep palpation directly over the joint using the palm of
the pulse is weak or nonexistent, thrombosis of the iliac the hand. At a walk, a stifle‐out, hock‐in, toe‐out gait
artery may be contributing to the lameness. Pressure can (external rotation) is frequently observed, with an
be applied to the greater trochanter, and if painful, middle apparent shortening of the limb length (Figure 2.97).
gluteal muscle strain or trochanteric bursitis (whirlbone From the side, the affected limb may appear to be
disease) should be suspected . Complete fractures of the straighter than the contralateral limb. With the metatar­
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femur usually result in non‐weight‐bearing lameness with sus held in hand, the coxofemoral joint can be manipu­
severe swelling and limb shortening due to overriding of lated into extension, flexion, and abduction to check for
the fracture (Figure 2.96). Femoral neck fractures are evidence of pain and crepitation. Additionally, the hip
more difficult to diagnose because they typically cause can be intermittently flexed and auscultated with a
less swelling and lameness than diaphyseal femoral frac­ stethoscope at the same time to identify crepitation.
tures. With time the swelling may migrate distally on the Limb abduction is often painful to horses with hip con­
medial side of the thigh, giving the impression that the ditions, and repeated limb abduction will often exacer­
distal femoral region is involved. bate the lameness.