Page 273 - Canine Lameness

15.8 nfraspinatus Disease 245

(A)

(B)

(C)

(D) SHOULDER REGION

Figure 15.14 Infraspinatus contracture: (A, B) clinical presentation and (C, D) stretching of the
infraspinatus muscle: (A) classic stance showing external rotation of the lower limb with elbow
adduction; (B) severe infraspinatus muscle atrophy; (C) stretching and palpation of the muscle with
extension of the shoulder joint while performing limb adduction and internal rotation; (D) stretching of
the muscle with flexion of the shoulder joint while performing limb adduction and internal rotation, note
that palpation of the muscle is not possible when manipulating the “down” limb to create excessive
adduction and internal rotation.

When infraspinatus contracture occurs, the patient has a very distinctive appearance of their
limb carriage. During ambulation, the elbow is adducted and the patient circumducts the limb,
while flipping the paw to place it (Videos 15.2 and 15.3). When static, the distal antebrachium and
paw can be observed to be externally rotated, while the elbow remains adducted, with varying
degrees of shoulder abduction (Figure 15.14). This may also manifest in an elevated limb (i.e.
abducted) if the patient is placed in lateral recumbency. Severe, visible muscle atrophy isolated to
the infraspinatus muscle is also generally present.