Specialty exam results The results of the specialty exams are very much what we expected based on the history and physical exam. The specialty exam results, in conjunction with the history and physical exam, rules out trauma and leads us to a diagnosis of developmental joint disorder, namely hip dysplasia. Orthopedic Exam (sedated) Positive Ortolani sign bilaterally-indicates hip joint laxity in conjunction with hip dysplasia ROM 130 degrees in both hip joints- has increased ROM Cranial drawer negative bilaterally Ð rules out stifle joint problem ( ligaments are intact) No crepitation or joint instability- because Jocelyn is young, she hasnÕt yet developed severe arthritis; therefore, would not have crepitation yet. No joint taps attempted Radiographs OFA = Orthopedic Foundation for Animals- certifies hips Moderate to severe HD (Grade 6/7 or 7/7) Ð significant subluxation where femoral head is almost completely out of hip socket. Beginning of secondary arthritic changes- starting to see flattening of femoral head; acetabular rim changes- ostephytes; shallow acetabulum; some abnormal bone pattern changes No notable fractures to pelvis or femur- indicates that not due to trauma Positioning for OFA view: dog on back, femurs extended parallel to each other, knees rotated slightly inward. Can also do new evaluation called Penn Hip- this measures passive hip laxity which is thought to be a predicting factor. Hips are compressed to determine where the femoral head and acetabulum coincide. The hips are distracted using a special device. The distance the head can be moved from the center is measured. This measurement is called a distraction index (DI). DI greater than 0.07 indicates hip dyplasia, less than 0.03 is normal. This method shows promise, but OFA still considered standard Discrepancies between our Plan of Action and the Specialty Exams that were performed: We suggested bloodwork, along with a full orthopedic exam and readiographs. We believe that this was justified because it would help determine whether there may have been a dietary component to this dogÕs problem. It is very possible that improper diet (feeding a maintenance food instead of growth food, which has less calcium and phosphorous) could lead to joint disorders because it causes improper skeletal growth. ). Bloodwork could also rule out infectious arthritis as a cause.