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Pelvic radiography
A routine pelvic radiographic series should include a lateral and ventrodorsal view. The lateral view is helpful to evaluate concomitant lesions of the caudal lumbar
and lumbosacral spine, the pelvic canal and the caudal abdominal soft tissues. Periosteal reactions along the pelvic margins may be seen with prostatic cancer and are often best seen in the lateral view. The coxofemoral joints are more difficult to evaluate as there is superimposition with the pelvis. Ventrodorsal projections can be obtained with the pelvic limbs extended which
is the standard view for evaluation of the coxofemoral joints. To evaluate for joint alignment and possible laxity it is very important to have proper positioning without axial rotation, otherwise the coxofemoral joints can artificially look better or worse than they are. Good positioning
is recognized by symmetry of the ilial wings, similar
size and shape of the obturator foramina and centered position of the spinous processes of the caudal lumbar spine. The femora should be parallel with the patella centered over the femoral trochlear groove. This is only possible in the heavily sedated patient as muscle tone otherwise prevents extension and internal rotation of the proximal pelvic limbs.
Flexed ventrodorsal projections are particularly useful when evaluating the lumbosacral junction for endplate defects, and in dogs and cats with suspected femoral neck fractures. Femoral neck fractures (traumatic or developmental as with slipped capital physes in cats) can be minimally displaced and difficult to detect in extended hip views as the fracture is reduced through positioning.
Symmetric positioning of the pelvis is also very important when evaluating patients for aggressive or traumatic lesions of the pelvis. Slight rotation can occasionally produce an unusual projection of a portion of the
pelvis resulting in over- or underinterpreting changes
in bone opacity. Other artifacts that can be problematic is superimposition of fecal material in the rectum. Gas lucency within the fecal material my result in the false impression of a radiolucent lytic lesion. It also hinders interpretation of the complex bone structure of the sacrum and cranial coccygeal vertebrae. Presence
of gas in the anal sacs results in rounded radiolucent “lesions” superimposed over the ischium and should not be confused with a pathologic aggressive lesion.
Additional, specialized pelvic views to evaluate dogs for hip dysplasia include distraction methods (PennHIP for example) and dorsal acetabular rim views that are mostly used for surgical planning.
References
1. Vet Clin North Am Small Anim Pract. 2016, 46(2): 265-75.
2. Vet Clin North Am Small Anim Pract.2018, 48(1): 85-94.
3. Vet Clin North Am Small Anim Pract. 2017, 47(4): 777-793.
Your Singapore, the Tropical Garden City
WSV18-0043
SVA REHABILITATION
IS CANINE REHABILITATION AND WHY SHOULD I ADD IT TO MY PRACTICE?
J. Van Dyke1
1Canine Rehabilitation Institute, Faculty, Wellington, USA
WHAT IS CANINE REHABILITATION AND WHY SHOULD I ADD IT TO MY PRACTICE?
Janet B. Van Dyke, DVM,
Diplomate American College of Veterinary Sports Medicine and Rehabilitation
Wellington, Florida
USA
janetvandyke@me.com
Canine rehabilitation is the application of physiotherapeutic techniques to evaluate and treat musculoskeletal impairments in our canine patients. It incorporates the use of objective outcome measures (goniometers, girthometers, etc.), manual assessments (including palpation, joint glides, and neurological assessment), gait analysis, and special tests brought from the field of human physiotherapy. This allows the therapist to tease out the specific structure and tissue type causing the impairments.
The therapist evaluates the presenting complaint, subjective information from the owner, and objective assessment carried out during the examination to create a problem list. Each item on the problem list is addressed in the plan of care.
Therapeutic plans generally involve a combination of manual therapies (joint mobilizations and soft tissue mobilizations), physical modalities (laser, therapeutic ultrasound, e-stim, shockwave), and therapeutic exercises. The modalities are generally used to prepare the tissues for the manual therapies and therapeutic exercises. Physical modalities should never be the sole therapeutic method applied to any patient.
Therapeutic exercise plans are based upon the weight bearing status of the patient, with early interventions focusing upon functional weight bearing exercises, later progressing to functional strengthening exercises. All exercise plans incorporate proprioception, balance, strength, flexibility, and endurance. Exercise equipment includes physioballs (shaped as rolls, peanuts, eggs, donuts and balls), cavaletti poles, therapy band, rocker/ wobble boards, and treadmills.
Physical modality parameters are chosen based upon the acuity of the injury. They are used to prepare the tissues for additional therapy and can generally be applied by trained veterinary nurses. The most commonly used physical modalities include neuromuscular electrical stimulation, laser, therapeutic ultrasound,
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