Current Trends and Approaches in Lameness Diagnosis
At the AAEP Blue Ribbon Panel Research meeting, in Ft. Collins, Colo., Andy Bathe, MA, VetVMB, DEO, Dipl. ECVS, MRCVS, of Rossdale & Partners in the United Kingdom, spoke on improvements in technology to aid in lameness diagnosis. He said lameness is the most important cause of wastage in the equine industry.
Diagnostic techniques are often subjective and based on practitioners’ experience, and Bathe speculated whether gait analysis could become more objective in its application to lameness.
When using diagnostic nerve blocks, he said it is important to record findings and data as one progresses through the exam. With the advent of digital radiography, there is improvement in radiographic quality, but he expressed concern that technique is still the most important factor, and technique is dependent on veterinarian skill and understanding of the areas being imaged. However, digital ultrasound equipment is able to image more structures than ever before, so operator proficiency to acquire good images is not as crucial as in previous decades.
In reviewing other diagnostic tools, Bathe recommended nuclear scintigraphy as an excellent technique for identifying suspected fractures, but it should not be used as a "black box" to evaluate a low-grade lameness. Rather, the lameness should be worked up in a systematic manner with a thorough clinical exam, diagnostic nerve blocks, and radiology and/or ultrasound as appropriate. Any images obtained through high-tech equipment must be correlated with the horse’s clinical presentation
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