Chapter 1 Lameness Examination
If your horse is lame in his shoulder, take off his shoes.… Young and inexperienced practitioners are quite too apt to commit the error of overlooking the examination of the foot, looking upon it as a matter of secondary importance, and attending to it as a routine and formal affair only.
As the twenty-first century continues, the extent of change in the diagnosis of lameness in the horse depends on the individual’s clinical and ideological perspective. A veritable explosion of new imaging methods such as digital radiography, computed tomography, and magnetic resonance imaging has advanced the current understanding of many musculoskeletal abnormalities. Yet to accurately assess clinical relevance, the clinician must possess a feel for the horse, developed only by careful clinical examination, a procedure that has changed little in hundreds of years. Successful detection of equine lameness does not so much require knowledge of science as it does art. Inasmuch as art is defined as “skilled workmanship, craft, or studied action,”2 the lameness examination demands artistic experience acquired by years of clinical practice and working and learning from experienced practitioners. From Liautard’s advice more than 100 years ago to that of modern lameness diagnosticians, the change in the basic skills of lameness diagnosis may be small.
Development of the artistic skills needed to become a true lameness diagnostician requires a thorough, somewhat methodical approach, much like that of a crime scene detective. I often refer to the lameness diagnostician as a lameness detective, and although this statement may lack sophistication, in reality, how boring would the task be if the horse could talk? To make a horse talk to you through careful palpation and observation is the essence of the lameness examination, yet most difficult to teach. Great lameness diagnosticians likely possess this ability to read or feel the horse and skilled, workmanship-like qualities to appreciate the art in lameness diagnosis. Some, with the added ability to share this knowledge effectively, have influenced clinicians more than others simply by writing about those experiences. In the early twenty-first century, Ross and Dyson’s Diagnosis and Management of Lameness in the Horse chronicled the exhaustive clinical experience of over 100 authors worldwide to capture the essence of the subject at that time.3 Moving figures captured as video segments on an accompanying CD and individual chapters detailing lameness distribution among different sporting activities complemented basic and advanced material.3 The book quickly became a staple of every lameness diagnostician’s library. In the mid-to-late 1900s, Adams had the most profound influence with his teachings and writings. His former students and friends acknowledge his artistic talent, gained primarily from a ground-up approach to the lame horse, and his profound interest in corrective shoeing. More important, Adams’ original lameness notes became his classic textbook.4 For most clinicians, Lameness in Horses