Page 386 - Canine Lameness

358 20 Hip Region

(A) (B)

Figure 20.6 Coxofemoral luxation palpation: (A) lateral radiograph of a patient with craniodorsal coxofemoral
luxation; the location of the greater trochanter (yellow star) is on a “line” between the cranial dorsal iliac spine
(red star) and ischiatic tuberosity (blue star) while in a (B) normal dog it is located below this line.

cranial dorsal border of the wing of the ilium, and the ischiatic tuberosity will form a triangle with
the greater trochanter positioned distal to a line between the cranial dorsal iliac spine and the
ischiatic tuberosity. This normal triangle becomes a line when the coxofemoral joint is luxated in a
craniodorsal direction with the greater trochanter being easily palpated between the two other
landmarks (Figure 20.6). Additionally, the clinician’s thumb may be placed between the greater
trochanter and ischiatic tuberosity in the ischiatic notch and the femur externally rotated to palpate
for a luxation. If the hip is luxated the clinician’s thumb will be pinched with this motion, but if it
is not luxated the thumb will be displaced with this motion.
Conversely, with ventral hip luxation the affected limb appears longer than the contralateral
normal limb, and the limb is held in an abducted position with internal rotation. The greater tro-
HIP REGION within the obturator foramen, inhibiting internal rotation and adduction of the femur.
chanter will be in a more medial location than expected, and the femoral head may be entrapped

20.4.3 Diagnostics
Diagnosis of CFL is confirmed via orthogonal radiographs (standard ventrodorsal and lateral
views; Figure 20.7). These should be thoroughly evaluated for concurrent trauma such as acetabu-
lar or pelvic fractures, slipped capital physeal fractures and fractures of the greater trochanter in
young patients, femoral head or femoral neck fractures, and SI luxation. Evidence of HD should
also be noted, as this affects treatment recommendations. At least, thoracic radiographs should be
considered in all cases of known trauma.

20.5 Hip Dysplasia

HD is a developmental disease where there is joint laxity and inadequate coverage of the femoral
head by the acetabulum. It is the most common orthopedic disease seen in dogs (King 2017). The
exact etiology is unknown; however, several studies have shown it to be a genetic disease with a
complex inheritance pattern (numerous genes), which is likely influenced by environmental
factors that influence its expression (Ginja et al. 2015; King 2017). Initially, there is laxity of the