Peer-reviewed veterinary case report
How dog factors affect orthopedic flexion test results
By Grosjean, Diane et al.·Published in Frontiers in veterinary science·2022·Faculty of Veterinary Medicine·View original on PubMed →
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Original publication title: Effect of dog-related parameters on the flexion test outcome: A large cohort retrospective study on physiological and orthopedic pathological-related factors.
- Species:
- dog
Plain-English summary
A large group of dogs with orthopedic issues underwent a flexion test to help pinpoint joint pain. The test involved bending a dog's joint and observing any increase in limping afterward. Results showed that the test was accurate in identifying joint pain, with 82.8% of cases confirming the problem. Interestingly, factors like age, gender, and weight did not affect the test's outcome, but the initial lameness score and which joint was tested did play a role. This means that while the flexion test is a reliable tool for diagnosing joint pain, it’s most effective when combined with a thorough orthopedic exam.
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Abstract
OBJECTIVES: This retrospective study evaluates the dog-related factors of variation influencing the outcome of the flexion test (FT), when performed to localize pain to a joint area, on a large group of canine orthopedic patients. MATERIALS AND METHODS: The selection criteria for this retrospective study were dogs undergoing a FT in a referral orthopedic clinic between 2009 and 2020 with a complete medical record. The canine FT, described in a previously published protocol, was performed on dogs presented with an orthopedic problem. In summary, a dog's joint, identified as suspected of an orthopedic problem according to the clinical examination, was flexed for 1 min before walking 15 m on a hard and even surface. The FT was considered positive if the lameness increased after the application of the FT and negative when it remained unchanged. Statistical analysis was performed to determine which of the following criteria could influence the outcome of the flexion test: age, gender, neutered status, weight category, tested joint and initial lameness score. RESULTS: Over 1,161 patients' files were collected and analyzed for this research. The FT showed 82.8% (95%IC: 80.5-84.9) of true positives and 17.2% of false negatives. None of the patient's intrinsic characteristics influenced the outcome of the test (age, gender, neutered status, and weight category). The orthopedic parameters, such as the initial lameness score and the tested joint, showed to have a statistically significant influence on the outcome of the test. CLINICAL RELEVANCE: The FT is an easy-to-perform technique presenting reliable results on most joints. This test presents an interest when performed in addition to a complete orthopedic examination to localize pain to a joint area. Only the orthopedic pathological-related parameters such as the lameness score and the tested joint seem to influence the outcome of the FT. The FT is not influenced by the physiological-related characteristic of the patient (age, weight category, sex, and neutered status).
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36590796/