Page 317 - Canine Lameness

18.3 ­FractFres ofctrf rFesral reg o 289

18.3.2 Physical Exam
When the injury is recent, the affected limb is usually carried. There may be an angular deformity
evident at or distal to the tarsocrural joint. Because of the acute nature of the injury, physical exam
findings usually show severe pain upon tarsal manipulation requiring sedation to perform a full
examination and diagnostics of the limb. Examination of the limb should include placing the tar-
sus through full range of motion, evaluation for joint effusion, and stress testing of the limb in
varus and valgus stress as well as applying dorsal and plantar stress (Figure 18.4). If the distal tibia
is held in position while the metatarsus is manipulated, excessive flexion, extension, or mediolat-
eral motion may be elicited.

(A) (C) (E) TARSAL REGION

(B) (D) (F)

Figure 18.4 Physical examination steps to detect tarsal joint pathology: (A) to fully flex the tarsal joint,
the hip and stifle joint also have to be flexed; (B) isolated tarsal hyperextension can be performed by
grasping the tibia below the stifle and extending the tarsus with the lower hand – this allows the observer
to differentiate stifle from tarsal pathology; joint effusion is palpable (C) caudal and (D) cranial to the
lateral malleolus; (E) applying upward pressure from plantar while flexing the stifle stresses the distal
tarsal joints and may show instability; (F) the common calcanean tendon can be stretched by holding the
stifle in extension from cranially while flexing the tarsus.