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Is this lameness orthopaedic or neurological?

image of Is this lameness orthopaedic or neurological?
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Abstract

For most of us who see orthopedic and neurologic gait abnormalities in cats or dogs, differentiating the two is not difficult. We look for obvious deficits such as ataxia or paresis to confidently walk down the neuro route, or evaluate with a few practised manoeuvers joint effusion, instability or pain, taking us readily down the ortho path. Of course, there is more to this, but we are often quite lucky that most of our patients present with relatively obvious signs of ‘neuro or ortho’. But what of the sneaky ones – the ones that have such an obvious lameness but despite our looking and walking and testing and probing do not give up the cause for it easily? This session dives deeper into the subtle nuances between orthopaedic and neurological lameness and how to determine which direction to pursue with further diagnostics and treatments. It can sometimes feel challenging to decide whether a gait abnormality is related to musculoskeletal or neurological abnormalities, but the differentiation is important to plan further diagnostics, or even refer appropriately! This determination is rarely ever done on the basis of further investigations, no matter how advanced. It is almost always achieved on the basis of clinical history, gait evaluation and clinical examination. This session draws on the experience of two clinicians who are well-used to investigating and managing both musculoskeletal and neurological gait abnormalities. It provides easy-to-remember, practical tips, addressing useful aspects of the clinical history (what to ask), gait evaluation (what to look for) and clinical examination (what to test), that will give the best possible chance of correctly identifying the cause of lameness in future patients.

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