Dyson S
Equine Vet J. 1986 Jan;18(1):25-8. doi: 10.1111/j.2042-3306.1986.tb03530.x.
Methods of investigating horses with suspected shoulder lameness are described and discussed. The gait of shoulder lameness is characterised and compared with that of lower forelimb lameness. If lameness is slight, differentiation may be difficult, but if moderate, upper forelimb lameness usually results in shortening of the cranial phase of the stride and a low limb flight. Clinically, it may not be possible to differentiate between shoulder and elbow lameness without intra-articular anaesthesia. Practical aspects of intra-articular anaesthesia of the shoulder joint are reviewed. Synovial fluid must be retrieved to ensure that the needle is intra-articular. Up to 60 mins may elapse after injection of local anaesthetic before significant improvement occurs. Lameness is often improved rather than eliminated. A technique for standing radiography of the shoulder is described and the limitations of assessing a joint only by lateral projections are highlighted. There may be difficulties in positioning weanling foals and yearlings, resulting in superimposition of the shoulder joint, cervical and thoracic vertebra and ribs. It is concluded that a combination of a thorough clinical examination, faradism, local anaesthesia, synovial fluid analysis and radiography usually enables an accurate diagnosis to be reached.
本文描述并讨论了对疑似肩部跛行马匹的调查方法。阐述了肩部跛行的步态特征，并与前肢下部跛行的步态进行了比较。若跛行症状较轻，鉴别可能会有困难，但如果症状中等，前肢上部跛行通常会导致步幅的颅相缩短和肢体低位摆动。临床上，若不进行关节内麻醉，可能无法区分肩部跛行和肘部跛行。本文回顾了肩关节关节内麻醉的实际操作要点。必须抽取滑液以确保针头位于关节内。注射局部麻醉剂后，可能需要长达60分钟才会有明显改善。跛行通常会有所改善而非消除。本文描述了一种肩部站立位X线摄影技术，并强调了仅通过侧位投影评估关节的局限性。给断奶幼驹和一岁马定位可能会有困难，导致肩关节、颈椎、胸椎和肋骨重叠。结论是，全面的临床检查、感应电疗法、局部麻醉、滑液分析和X线摄影相结合，通常能够做出准确诊断。
