Approach to the orthopaedic patient

Orthopaedic patients represent a moderate proportion of first opinion practice caseloads (Belshaw et al, 2020). To reach a diagnosis efficiently, clinicians need to appreciate the importance of obtaining an accurate history, observation of the standing animal, gait analysis, orthopaedic and neurological examination and how their findings influence the selection of appropriate diagnostic tests to confirm the suspected diagnosis. The methodical approach to every orthopaedic patient listed in this article will help clinicians in this process.

Taking the patient's history can be one of the most time-consuming and challenging parts of the orthopaedic examination. General questions should be followed by focused questions. The owner should be asked to provide information about signalment, diet, duration of ownership, vaccination status, the function of the patient (for example, working, competition or pet animal), current medications, previous injuries or illnesses, exercise regimen and travel history. Signalment is particularly important, as breed, sex and age can predispose to certain orthopaedic diseases, such as elbow dysplasia (Baers et al, 2019) and hip dysplasia (Lopez and Schachner, 2015). Similarly, a poorly balanced diet has been associated with rickets, hypervitaminosis A and hypervitaminosis D (Bennett, 1976).