INNOVATIVE DIAGNOSTIC TECHNOLOGIES
in confirming the clinical impression in this case given the relatively subtle visual nature of the lameness. The app provides a color-based interpretation of the lameness in a summary page. The degree of lameness decreases from red, through orange, yellow, gray, and then to green, where no asymmetry is present. This can be helpful in discussion with clients as it is visu- ally simple and generally well received. There is also more in-depth data within the app relating to each limb, each stride analyzed by the app, and whether the lameness is characterized more as an impact or push-off
lameness.Note in this case that the lameness is characterized as orange, improving to gray follow- ing the block.
Imaging
Fig. 4. MRI image demonstrating the injury to the collateral lig- ament (arrow).
diagram showing the degree of lameness, character of lameness (impact/push off), etc. (Fig. 1). The turn- around time allows almost real-time objective data to bemade available. It also lends itself to the sequential analysis of a horse where diagnostic analgesia is employed to localize the lameness, a common sce- nario. Typically, one can examine a horse, upload the video for analysis, perform diagnostic analgesia, and have the results back and be ready to use the app again to assess the outcome. This is particularly help- ful in the case of a low-grade lameness or where diag- nostic analgesia improves but does not completely resolve a lameness.
3. Results
This app has become part of the daily routine of 3 of the 4 clinicians in the author’s practice. Case-based examples of the application in practice are presented as follows:
Case 1: 2011 Irish Sport Horse Showjumper
History This mare had a forelimb lameness of 4months dura- tion, which started the day after a competition. She had been managed with restricted exercise during that period, and the distal interphalangeal (DIP) joint had been medicated historically by another clinician. The lameness was reportedly unchanged during that period, showing no significant improvement.
Resting Exam Amild effusionwas present in the left foreDIP joint.
Moving Exam
Amild (grade 1/5) left foreleg lamenesswas present in both a straight line and in a circle on both firm and soft surfaces. A palmar digital nerve block abolished the lameness, with the information provided by the app corroborating that view (Fig. 3). This was helpful
360 2022 / Vol. 68 / AAEP PROCEEDINGS
A small osteophyte was present on the palmaroproxi- mal aspect of the navicular bone. However, this was considered insufficient to account for the lameness. Given the duration of the lameness and the lack of response to rest and medication of the DIP joint, the mare was referred for advanced imaging in the form of magnetic resonance imaging (MRI). This demon- strated the presence of a DIP joint collateral ligament injury (Fig. 4).
Case 2: 2018 National Hunt Thoroughbred Racehorse
History This filly went lame in front some 3weeks prior to presentation. She had a short period of rest, came sound, resumed exercise, andwent lame again.
Resting Exam No localizing signs.
Moving Exam
Amoderate (grade 2/5) left foreleg lameness was pres- ent. A combined low 2-point and abaxial sesamoid nerve block did not alter the lameness. A subcarpal nerve block abolished the lameness. The clinical impression at this time was that a very subtle right foreleg lameness was now present. This was corrobo- rated by the data provided by the app, increasing cli- nician confidence in the view that the lameness was bilateral in this case (Fig. 5).
Imaging
Ultrasound examination demonstrated findings con- sistent with proximal suspensory desmitis in both forelimbs. In addition, a small avulsion was present in the left fore proximal cannon (Fig. 6). This filly was subject to restricted exercise for
6weeks, at which time she was sound. She resumed an increasing plane of exercise and returned to train- ing uneventfully.
Case 3: 13-Year-Old Irish Sport Horse 3-Day Eventer
This horse was long listed for selection to compete at the European Championships 2022, Herning, Denmark. While ongoing monitoring of these horses is a regular feature of their management
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