Page 153 - Adams and Stashak's Lameness in Horses, 7th Edition

Examination for Lameness 119

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Figure 2.107. Positioning to perform hock or tarsal flexion of the
hindlimb where the limb is held by the hoof.

the test rather than jogging off at a smooth pace. The Figure 2.108. Flexion of the stifle is performed by pulling the
response to tarsal flexion should nearly always be com­ hindlimb caudally and lifting up on the distal tibia.
pared to the opposite limb because an asymmetrical
response is often an important clinical finding. no response to flexing all of the joints at one time, the
potential for getting positive responses to individual
STIFLE FLEXION flexion tests is thought to be unlikely. Full‐limb fore­
limb flexion is performed by grasping the foot and lift­
The stifle flexion test is often used in an attempt to ing the leg to flex the fetlock, carpus, and elbow. The
separate stifle pain from tarsal pain in horses that respond opposite hand is placed on the metacarpus, and the
to a tarsal flexion test. In most cases the stifle flexion test limb elevated and pulled forward to extend the shoul­
will flex the hock less than the tarsal flexion test will der (Figure 2.109). Full‐limb hindlimb flexion is per­
flex the stifle. In many cases it can be more specific for formed by grasping the foot and flexing the fetlock,
stifle problems, but this is debatable. It is performed by hock, and stifle simultaneously. The hindlimb is pulled
grasping the distal tibia and pulling the limb backward out behind the horse to help flex the stifle (Figure 2.110).
and upward until maximal stifle flexion is achieved The limb is usually held in position for 30–60 seconds.
(Figure 2.108). It is best to face toward the back of the A negative response is thought to suggest that individ­
horse with the limb in front of you when performing this ual flexion responses will also be negative, but this has
test (Video 2.6). The limb is held in this position for 60 not been determined definitively for either the forelimb
seconds and the horse is trotted off. Some clinicians prefer or hindlimb.
to perform the stifle flexion test before the hock flexion
test, while others do the opposite. A positive tarsal flexion NAVICULAR WEDGE TEST
together with a more positive stifle flexion may suggest
that the lameness is due to a stifle problem and vice versa. The navicular wedge test can be performed in two dif­
ferent ways. A wedge (usually a block of wood) may be
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FULL‐LIMB FORELIMB AND HINDLIMB FLEXION placed beneath the frog of the affected foot while the
opposite limb is held up. It is thought to apply direct
Full‐limb forelimb and hindlimb flexion tests can be pressure to the frog region, similar to hoof testers, and is
used as quick screening tests to determine whether usually performed for 30–60 seconds, after which the
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more isolated flexion tests may be necessary. If there is horse is trotted off. Alternatively, the toe is forced into an