Lameness Evaluation

A lameness work-up is a series of examinations and tests which are undertaken to identify the location of a lameness.

1. Detailed History, it is important to start with these basic questions:
  • When was the lameness first noticed?
  • What was the horse doing around the time the lameness started?
  • Has the lameness worsened since it was first noticed?
  • Does the horse have any previous known lameness issues?
  • What is the use/intended purpose for this horse?
2. Conformation and standing examintaion

Assessment of conformation is performed with the horse standing squarely on flat ground.  This allow evaluation of hoof-pastern axis, limb angulation and joint loading/effusions to be assessed.  Palpation of the neck, withers, back and pelvis are also performed with the horse stood quietly to give further information regarding localised points of pain.

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3. Evaluation of Movement

The horse is assessed in a straight line at the walk, trot and canter.  Further examination on the lunge at walk, trot and canter may be necessary as not all lameness can be detected in the straight-line motion.  The lame leg is identified during this examination in addition to any abnormalities of foot placement, arc-of-flight and limb motion.

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4. Flexion Testing

Flexion Testing is useful to induce a temporary strain of the joint which can exacerbate a lameness and aid in localising the lameness to a particular sight. Examination of the contra-lateral limb can be performed to establish a baseline or to assess if the lameness is bilateral.

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5. Perineural or intra-articular analgesia

Perineural or intra-articular analgesia (nerve and joint blocks)involve injecting local anaesthetic either around nerves or directly into joint(s).  It is quite common for horses with lameness problems not show any outward signs of heat, swelling or pain on palpation which would aid in localising the site of the lameness.  Desensitizing particular areas within the affected limb and re-evaluation of the lameness enable the horse to demonstrate an improvement in lameness when the affected site is no longer the source of pain.

6. Diagnostic Imaging

Once the source of the pain has been localised, imaging is then performed to identify the cause of the lameness.  The main imaging modalities used are:

  • Radiography (bone structures): The portable x-ray machine enables radiographs to be taken on property or to assess injuries ‘in the field’.  The digital images produced can be viewed immediately and the ability to manipulate the image facilitates diagnosis of subtle lesions.  The images are then uploaded onto a database and can be emailed to specialists as required.
  • Ultrasonography (soft tissue structures): The battery powered portable ultrasound machine is used on property (ideally in a darker stable) to assess ligaments and tendons for injury.
7. Therapeutics/Management

Depending on the duration of the lameness, therapeutics can involve short term inflammation management and long term rehabilitation programs.

Additional treatment options to be considered include:

  • Extracorporeal Shock Wave Therapy
  • Therapeutic Ultrasound
  • Red Light Therapy
  • Physiotherapy