Page 63 - Canine Lameness

3.2 The Orthopedic Examination 35

Table 3.2 Individual steps of the orthopedic examination.

Examination procedure/
Region Step structure Comment
Pelvic limbs 1 Evaluate weight Pulling caudally on the limbs can detect the affected
distribution limb
2 Paw replacement Delayed response indicates neurologic disease
3 Palpation for asymmetry Muscle atrophy can be disuse or neurogenic (i.e.
(muscle mass/soft tissue secondary)
swelling/masses, etc.) Pain, swelling, and masses indicate local pathology
(e.g. trauma, infection, neoplasia, etc.)
4 Tarsal joint effusion Indicates articular disease
5 Stifle joint effusion Indicates articular disease, most frequently cranial
cruciate ligament disease (CCLD)
Spine 6 Tail lift Pain indicates lumbosacral disease
7 Paraspinal palpation Pain indicates neurologic disease
8 Neck range of motion Pain indicates neurologic disease
Thoracic 9 Evaluate weight Lifting up on the limbs can detect the affected limb
limbs distribution
10 Palpation for asymmetry Muscle atrophy can be disuse or neurogenic (i.e.
(muscle mass/soft tissue secondary)
swelling/masses, etc.) Pain, swelling, and masses indicate local pathology
(e.g. trauma, infection, neoplasia, etc.)
11 Elbow joint effusion Indicates articular disease, most frequently ED
12 Carpal joint effusion Indicates articular disease
13 Paw replacement Delayed response indicates neurologic disease
Distal 14 Evaluate nails, webbing, Frequent source of trauma, foreign bodies, etc.
pelvic limb and paw pad
15 PROM of all digits Pain indicates digit pathology – if painful, perform
PROM of individual digit/joints
16 Sesamoid palpation (#2, 7) Pain indicates sesamoid disease
Metatarsals 17 Long bone palpation Pain may indicate neoplasia, fracture
Tarsus 18 PROM Pain, reduced or increased range of motion,
indicates disease of the joint or surrounding soft
tissue structures
19 Varus and valgus stress Instability indicates collateral ligament disruption
20 Achilles tendon insertion Swelling at insertion indicates tendinopathy
Tibia 21 Long bone palpation Pain may indicate neoplasia (proximal and distal
tibia), fracture, and panosteitis
Stifle 22 PROM Pain, reduced or increased range of motion,
indicates disease of the joint or surrounding soft
tissue structures
23 Varus and valgus stress Instability indicates collateral ligament disruption
24 Evaluate for signs of Palpate for presence of medial buttress, pain on
CCLD hyperextension, and perform drawer and tibial
compression test. Note: effusion (evaluated in step
5) is also an indicator of CCLD
(Continued)