Musculoskeletal: physical examination - adult

p equis

Contributor(s):

Dallas Goble

Graham Munroe

Chris Whitton

Laura Quiney

Introduction

A thorough and systematic physical examination is important in all cases of lameness or poor performance.
Should include an evaluation of the horse's conformation, muscle development, symmetry and flexibility, as well as identification of areas of swelling, heat, pain on palpation or muscular tension Behavior: pain assessment.
Limbs should be palpated in the weight bearing and non-weight bearing positions.
Includes visual assessment, palpation and manipulative techniques.
For other age groups see Foal: evaluation - neonate Musculoskeletal: physical examination - foal.
Can yield potentially important information, however a lack of findings does not preclude injury.

Uses

Diagnosis of forelimb and hindlimb lameness.
Evaluation of back pain Musculoskeletal: back pain.
Part of conformation evaluation Musculoskeletal: conformation.
Part of neurologic examination Neurology: examination - adult Neurology: examination - foal.
Part of pre-purchase examination Pre-purchase examination.
Preliminary to gait evaluation Musculoskeletal: gait evaluation, manipulative tests Musculoskeletal: manipulative tests, local analgesia Anesthesia: analgesia - overview and other diagnostic tests, eg response to exercise Musculoskeletal: exercise response test, myelography Myelography.

Print off the Owner factsheet on Exercise intolerance / poor performance testing, Lameness examinations to give to your clients.

Advantages

Important information can be easily gained.
Non-invasive opportunity to examine horse at rest.
Minimal stress to animal.
Information can influence interpretation of gait, as well as influence the prognosis and treatment options of some pathology.

Disadvantages

Localizing signs are not always present → false-negative results.
Clinical signs often occur at sites distant to the source of lameness and therefore can be misleading if misinterpreted → false-negative results.
Requires reasonably relaxed horse to permit evaluation of response to palpation.
Individual variation of response to palpation and manipulation.
Wide range of 'normal' conformation Musculoskeletal: conformation, the assessment of which will still largely be based on empirical rather than scientific evidence.
Manipulation of fracture sites may → further soft tissue injury, even convert closed fracture Musculoskeletal: fracture to open.

Requirements

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Preparation

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Procedure

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Recent references from PubMed and VetMedResource.
James O, Payne R, Bathe A, Greet T & Wylie C (2016) Arthroscopy of the dorsal and plantar pouches of the tarsocrural joint for the treatment of osteochondritis dissecans in the horse: clinical features and follow‐up. Vet Surg 45 (8), 1049-1055 PubMed.
Barstow A & Dyson S (2015) Clinical features and diagnosis of sacroiliac joint region pain in 296 horses: 2004-2014. Equine Vet Educ 27 (12), 637-647 VetMedResource.
Parkes R, Newton R & Dyson S (2015) Is there an association between clinical features, response to diagnostic analgesia and radiological findings in horses with a magnetic resonance imaging diagnosis of navicular disease or other injuries of the podotrochlear apparatus? Vet J 204 (1), 40-46 PubMed.
Parker R (2015) Clinical features, diagnosis and management of fractures of the distal phalanx in horses. Livestock 20 (2), 107-110 VetMedResource.
Marneris D & Dyson S J (2014) Clinical features, diagnostic imaging findings and concurrent injuries in 71 sports horses with suspensory branch injuries. Equine Vet Educ 26 (6), 312-321 VetMedResource.
Holroyd K, Dixon J, Mair T, Bolas N, Bolt D M, David F & Weller R (2013) Variation in foot conformation in lame horses with different foot lesions. Vet J 195 (3), 361-365 PubMed.
Dyson S & Murray R (2011) Management of hindlimb proximal suspensory desmopathy by neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy: 155 horses (2003-2008). Equine Vet J 44 (3), 361-367 PubMed.
Dyson S & Murray R (2003) Pain associated with the sacroiliac joint region: a clinical study of 74 horses. Equine Vet J 35 (3), 240-245 PubMed.

Other sources of information

Ross M W (2011) Observation: Symmetry and Posture. In: Diagnosis and Management of Lameness in the Horse. 2nd edn. Eds: Ross M W & Dyson S J. Elsevier Saunders, USA.

Ross M W & McIlwraith C W (2011) Conformation and Lameness. In: Diagnosis and Management of Lameness in the Horse. 2nd edn. Eds: Ross M W & Dyson S J. Elsevier Saunders, USA.

Ross M W (2011) Palpation. In: Diagnosis and Management of Lameness in the Horse. 2nd edn. Eds: Ross M W & Dyson S J. Elsevier Saunders, USA.

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