Lameness Localization in Dogs: An Exploratory Study of the Translation of the Equine Flexion Test to Canine Orthopaedics

Abstract

Objectives The aim of this study was to describe the method and feasibility of the flexion test (FT) as a diagnostic tool to localize lameness on dogs. Study Design Canine FT was designed and based on the FT routinely used on horses. In dogs, the test consisted in a flexion of a joint to its full range of motion for 1 minute. Eventual increased lameness was then evaluated. The gait was evaluated using a visual analogue scale. An increase in the lameness score compared with the baseline score was considered as a positive result.The method was described for every major joint of the appendicular skeleton and was evaluated in sound and lame dogs. To evaluate the feasibility, the FT was applied for 3 minutes in eight healthy dogs on all joints. On 27 clinically lame dogs, flexion was applied for 1 minute on the joints with a suspected pathology and on their contralateral side used as a control. Results The FT was feasible and well tolerated by the sound dogs on all joints and no positive results were recorded. On clinically lame dogs, lameness increased in 81.5% of dogs. These cases were afterwards diagnosed with an orthopaedic-related disorder and then defined as true positives. False negative results occurred in 18.5% of the lameness cases. Conclusion The FT is safe and easy to perform. It did not produce any false positive results. False negatives might occur in a minor number of cases, implying that a negative result does not exclude a joint pathology.

Effect of dog-related parameters on the flexion test outcome: A large cohort retrospective study on physiological and orthopedic pathological-related factors

“…The FT has also been used in dogs ( 23 ). When the basic orthopedic examination for joint effusion, thickening, range of motion, crepitus and pain is inconclusive, the FT can be incorporated into the clinical evaluation ( 23 ).…”

“…The FT has also been used in dogs ( 23 ). When the basic orthopedic examination for joint effusion, thickening, range of motion, crepitus and pain is inconclusive, the FT can be incorporated into the clinical evaluation ( 23 ). This method is easy to use and accessible to all small animal clinicians with no additional equipment costs.…”

“…The FT applied on dogs has been described in the literature as a flexion of a single joint to a full range of motion. This position is held for 1 min before the dog is released to walk immediately on a straight line on a homogeneous and hard surface of 15 m. This first definition available in canine medicine doesn't consider the force applied to the joint unlike some protocols described in equine medicine ( 9 , 23 ). This is because of practical limitations in dogs.…”

“…This is because of practical limitations in dogs. A preliminary study described the use of this tool in addition to the orthopedic examination as promising ( 23 ), but data are still lacking regarding the clinical accuracy of this tool when tested on a larger group of dogs. Inspired by equine colleagues, the FT was translated to dogs according to the protocol previously described in the literature ( 23 ).…”

“…A preliminary study described the use of this tool in addition to the orthopedic examination as promising ( 23 ), but data are still lacking regarding the clinical accuracy of this tool when tested on a larger group of dogs. Inspired by equine colleagues, the FT was translated to dogs according to the protocol previously described in the literature ( 23 ). In this study, the flexion test offered a significant lameness score increase ( p < 0.001) and a specificity of 100% after it was performed on a sample population of orthopedic lameness cases ( 23 ).…”