Keep one step ahead

...Keep one step ahead

MRI scans

can be an important tool in

diagnosing the cause of a foot lameness.

Investigation of foot lameness

All investigations should begin with a good history where

information such as recent injuries, changes in farrier,

changes in feeding and exercise levels can all be

discussed. A visual inspection will evaluate the stance,

conformation and symmetry; which can give vital clues to

possible areas of trouble.

Palpation (feeling) of the limb and foot will be performed;

heat or an increase in digital pulses can help in identifying

foot inflammation. The pulses may be easiest to feel along

the back of the fetlock and a comparison should be made

with the opposite leg. The application of hoof testers,

which are designed to apply pressure in selected areas of

the foot such as the frog or sole, can help localise foot

pain and may assist in diagnosing a bruised sole, an

abscess, nail bind, laminitis or heel pain.

In cases where the source of lameness is unclear or

needs confirmation the next step is the localisation of the

pain using a nerve block or joint block. Local anaesthetic

is placed around a nerve or into a joint or bursa to numb

the area. Once an area is ‘blocked’; if the horse becomes

sound we then know that area is relevant to the cause of

the lameness. We then need to image the area to identify

any abnormalities. This is most commonly done using

x-rays. We can visualise fractures, navicular degeneration,

osteoarthritis in the coffin joint, pedal bone changes

such as pedal osteitis or changes in position of the pedal

bone such as in laminitis. Sometimes if the lameness is

caused by damage to soft tissue structures, very little may

be seen on the x-rays and other imaging techniques need

to be used. Other techniques used include ultrasound

imaging. This can be used as well as nuclear scintigraphy

(bone scan), magnetic resonance imaging (MRI scan),

computed tomography (CT scan), thermography and

contrast venography.

history

visual examination

palpation (hands and hoof testers)

nerve and joint blocks

radiography

contrast venography

ultrasound

nuclear scintigraphy (bone scan)

MRI

thermography

Investigation of foot

lameness may involve: