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Measurement of angles of abduction for diagnosis of shoulder instability
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It has become a standard method in human medicine but it is still rarely performed in dogs: the measurement of angles of abduction for diagnosis of shoulder instability. This very interesting study compares abduction angles of shoulders with medial instability and unaffected shoulders in the same dogs and in age- and breed-matched dogs. The result: Determination of shoulder abduction angles should be included in the diagnostic protocol for forelimb lameness assessment in dogs!
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Dogs with medial instability of the shoulder (n=33) and 26 control dogs were included in this case-control study. They were sedated and positioned in lateral recumbency with both scapulas parallel to the table.
With the elbow and shoulder in extension, the non-recumbent limb was maximally abducted and the angle between the scapular spine and lateral aspect of the brachium measured with a goniometer; a digital image was taken from the cranial aspect.
Both techniques were performed in triplicate by 2 examiners.
Mean abduction angles for each shoulder were determined from goniometric measurements and image analysis.
Data were analyzed for significant differences between affected and unaffected shoulders, measurement techniques, and examiners. Strength of correlation between measurement techniques was determined.
RESULTS: Mean abduction angles for shoulders with instability (53.7+/-4.7 degrees goniometric, 51.2+/-4.9 degrees image) were significantly (P<.001) larger than for all unaffected shoulders (32.6+/-2.0 degrees goniometric, 30.9+/-2.3 degrees image).
In dogs diagnosed with instability, affected shoulders had significantly (P<.001) larger abduction angles than the contralateral (unaffected) shoulders.
No significant differences were identified between right and left shoulders for control dogs, measurement techniques, or examiners.
A strong (r=0.90) significant (P<.001) positive correlation between measurement techniques was noted.
CONCLUSIONS: Shoulder abduction angles measured under sedation provide objective data for diagnosis of shoulder instability in dogs.
Shoulders with clinical and arthroscopic evidence of medial instability have significantly higher abduction angles than shoulders that are considered normal. Thus, determination of shoulder abduction angles should be included in the diagnostic protocol for forelimb lameness assessment in dogs.
Source: Cook JL, Renfro DC, Tomlinson JL, Sorensen JE. (2005): Measurement of angles of abduction for diagnosis of shoulder instability in dogs using goniometry and digital image analysis. In: Vet Surg. 2005 Sep-Oct;34(5):463-8.
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