Page 390 - Canine Lameness

362 20 Hip Region

(A) Figure 20.9 When performing the
(B) Ortolani maneuver (A) gentle dorsal
pressure during adduction of the hip is
applied. If laxity is present, this (B)
results in subluxation of the hip joint.
The (C) limb is then abducted, which (D)
results in reduction of the joint, which
can be palpated or heard as a “clunk,”
defined as a positive Ortolani sign.

(C) (D)

subluxation the greater trochanter may be palpated more dorsally than expected due to subluxa-
tion of the hip joint (similarly to CFL). Ortolani testing is not indicated in these patients as there is
HIP REGION no laxity in the progressive stages of the disease.

20.5.3 Diagnostics
Radiographs should be performed to confirm the diagnosis of HD and rule out the presence of
other pathology such as septic arthritis and neoplasia, or fractures of the femoral head/neck.
Radiographic positioning is imperative for accurate evaluation of laxity of the coxofemoral joint.
Standard films include a lateral pelvis, and a ventrodorsal view with the hips extended. For the
lateral view the ilial wings should be superimposed with one pelvic limb pulled in front of the
other. The ventrodorsal view should be performed so that the pelvis is straight, and the limbs are
extended and parallel to the imaging table. A straight pelvis will have symmetrical obturator
foramens, and the width of the wings of the ilium will be equal. If one side is wider than the other,
the patient is crooked (with the thinner side being elevated further from the table). Additionally,
the vertebrae should be assessed for alignment; with straight alignment, symmetrical transverse
processes and a spinous process centered on the body of the vertebrae will be observed. The femurs
should be parallel to the table or they will appear foreshortened. A portion of the lesser trochanter
should be visible and the patella should be within the trochlear groove with the fabellae bisecting
the cortices (Figure 20.10).
In young dogs, minimal to no OA may be noted, although evidence of subluxation or full
luxation may be present (which is generally assessed on the ventrodorsal leg extended view,