Page 104 - Canine Lameness

76 5 The Rehabilitation Examination

Table 5.5 Previously published landmarks for placement of goniometer arms.

Stationary (=proximal) arm Motion (=distal) arm

Distal landmark Proximal landmark Distal landmark Proximal landmark

Shoulder Spine of scapula Lateral epicondyle of Insertion of the
the humerus infraspinatus
muscle on the
greater tubercle of
the humerus
Elbow Lateral epicondyle of Insertion of the Cranial to caudal Lateral epicondyle
the humerus infraspinatus muscle midpoint of the of the humerus
on the greater antebrachium at the
tubercle of the level of the ulnar
humerus styloid process
Carpus Cranial to caudal Lateral epicondyle of Long axis of metacarpal bones III and IV
midpoint of the the humerus
antebrachium at the
level of the ulnar
styloid process
Hip Tuber sacrale Tuber ischiadicum Lateral epicondyle of Greater trochanter
the femur
Stifle Lateral epicondyle of Greater trochanter Lateral malleolus of Craniocaudal
the femur the fibula midpoint of the
proximal aspect of
the tibia at the level
of the tibial crest
Tarsus Lateral malleolus Craniocaudal Long axis of metatarsal bones III and IV
midpoint of the
proximal aspect of the
tibia at the level of the
tibial crest
Source: Adapted from Jaegger et al. (2002) and Freund et al. (2016).

will therefore have less of an influence on the PROM evaluation. Also, it is important to note that
PROM testing in a standing position must be differentiated from measuring standing angles; the
latter has recently been described and evaluates the posture of a dog rather than range of motion
of a joint (Sabanci and Ocal 2018).

5.2.2 How to Interpret Passive Range of Motion Testing
PROM testing determines whether joint range of motion is abnormal and which tissue type
restricts range of motion. This information can be helpful in determining appropriate subsequent
diagnostic steps. For example, when testing a patient’s shoulder extension PROM, if the end‐feel
is elastic and the PROM goniometric measurement is 140°, the observer should conclude that
PROM may be decreased because of muscle pathology (as indicated by the elastic end‐feel;
Table 5.1). Several muscles limit shoulder extension (Table 5.3), including the latissimus dorsi,