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Examination of
Musculoskeletal System

General considerations
Examination of muscle abnormalities
Myopathy
Myositis
Muscular hypertrophy
Examination of bones
Osteodystrophy
Osteomyelitis
Osteochondritis
Osteopetrosis
Tumors of bones
Examination of joints
Degenerative and inflammatory
disorders of joints
Infectious arthritis
Rheumatoid arthritis
Navicular disease
Manchester wasting disease
GENERAL CONSIDERATIONS
Main function of the musculoskeletal system
is to support the body in order to ensure
normal locomotion and posture. The
affections of muscles, bones and joints lead
to abnormal locomotion and/or posture as
a major clinical entity. Abnormality in
locomotor action can be identified when

animal walks on its own in the presence of

a veterinarian or put on exercise by the
examiner. Musculoskeletal system generally
shows alterations during diseases of nervous
system. Severe systemic diseases often cause
muscular weakness leading to abnormal
movements and posture.
In this system, the clinical examination of
the affections of muscles, tendons, bones and
joints are discussed. The various terms of
these affections are as follows:
1. Myopathy: Myopathy is used for degeneration of muscles.
2. Osteodystrophy: It is degenerative disease
of bones.
3. Arthropathy: Arthropathy is the degeneration of joints.
4. Myositis: Myositis is used for inflammatory conditions of the muscles.
5. Osteomyelitis: Osteomyelitis is the inflammation of bones.
6. Arthritis: It is the inflammation of joints.
7. Abrachia: Abrachia is the absence of one
forelimb. It is a congenital deformity.
8. Amelia: It is a congenital abnormality in
which all the limbs are missing. The
scapula or pelvic girdle are rudimentary
or intact.

50 Textbook of Veterinary Clinical and Laboratory Diagnosis

9. Apodia: Apodia is the absence of hind
limb. It is a congenital defect.
10. Micromelia: In this congenital defect, the
limbs are present with all parts but of
smaller size.
11. Adactylism: In this condition, all the toes
in a limb are absent at the time of birth.
12. Perodactyly: Perodactyly is the congenital
defect in which some toes in limbs are
absent.
13. Syndactylism: In this condition, the toes
of the limbs are fused together. This is
a congenital defect occurs mainly in
cattle and pigs.
14. Polydactylism: In this condition, in a limb
more number of digits may occur.
Polydactylism condition is mainly observed as congenital defect in horses and
pigs.
15. Brachydactylism: Brachydactylism is the
abnormal shortening of toes in animals.
16. Prognathism: Prognathism is a congenital
defect in which the more long jaw
condition occurs in animals. In horse, pig
mouth condition is the true example of
prognathism.
17. Brachygnathism: In this condition, the
occurrence of short jaw has been
observed as a congenital defect in animals, e.g. parrot mouth like condition
in horse.
18. Lordosis: In this condition, the spinus
process rubs against each other leading
to development of periostic osteophytes.
19. Kyphosis: Kyphosis is used for an
abnormal curvature and dorsal prominence of spine leading to hump back.
20. Scoliosis: In this condition, the abnormal
lateral curvature of vertebral column
occurs in animals.
21. Torticollis: Torticollis is the twisting of
neck with an unnatural position of
head.

EXAMINATION OF MUSCLE
ABNORMALITIES
Muscular examination is, generally, performed through general inspection and
palpation and the changes can be detected
by making a comparison on neighbouring
muscles. In muscles, atrophy may occur due
to reduction or curtailed use of muscles, e.g.
in radial nerve paralysis atrophy of triceps
brachii muscle occurs.
The tone of muscles increases which may
be continuous and is called as tonic spasms,
e.g. tonic spasms in tetanus. When the muscle
spasms are intermittant in certain diseases,
they are known as clonic spasm, e.g.
strychnine poisoning. During muscular spasm,
the rigidity of muscle is observed alongwith
firmness. In hypomagnesemic tetany, tonic
muscular spasms are observed in association
with excitement and panting respiration. One
can observe the muscle tremors through palpation, which occurs mainly due to chloride
deficiency and in cerebellum involvement.
Myopathy
It is a degenerative disease of muscles
characterized by muscle weakness, altered
posture and recumbency. The muscle becomes
swollen and hard, e.g. white muscle disease
in calves and lambs; azoturia in horses.
1. White muscle disease: It is common in lambs
and calves but may also occur in other
animals like pigs and dogs. The primary
cause is considered to be the vitamin E
deficiency or, selenium deficiency or
excess of legume feeding or excess of
polyunsaturated fatty acids in diet. It
occurs in three clinical forms viz. (a) stiff
form, which is characterized by stiff gait
and wobble and difficulty in walking.
Animal shows letharginess and not able
to get up. Head is carried low with
drooping posture; the condition is also

Examination of Musculoskeletal System

known as stiff lamb disease due to stiff
gait, (b) respiratory form is manifested by
respiratory distress due to involvement
of respiratory muscles particularly diaphragmatic and intercostal muscles, (c)
cardial form is characterized by weakness,
animal is unable to stand, rapid pulse, low
blood pressure, respiratory distress due
to exertion and sudden death. The level
of SGOT exceeds to 300 units.
The involved muscles can be palpated
as swollen, hard, and rubbery; the effect
is bilateral. In sheep, it is manifested like
scrapie.
2. Azoturia: In horses, it occurs as Monday
morning sickness, when horses are going
to work after a complete rest for few days
but given full ration. Animal feels pain in
lumbar region, sweating and shivering
occurs after exercise or when put to work.
Mostly the muscles of gluteal, femoral and
lumbar regions are involved which becomes swollen and hard. Urine becomes
dark brown in colour due to presence of
myoglobin; hence the disease is also
known as equine myoglobinuria. Animal
lies down and death occurs, if not cared
properly. Recovered animals take more
time to regain the atrophied muscles.
SGOT rises to 1000 units per ml serum with
hyperkalemia. In foals, it is characterized
by depression, stiffness, disinclination to
move, prostration and death.
Secondary myopathy occurs in cattle due
to recumbency leading to interrupted nerve
and blood supply. It has been observed in
hind limb of cattle which are recumbent for
more than 2 days.
Myositis
Myositis is the inflammation of muscles caused
by trauma, infection extended from neighbouring arthritis, osteitis, periosteitis, pyemia

51

and parasitic infections. It commonly occurs

in black quarter, actinobacillosis, blue tongue,
foot and mouth disease, sarcosporidiosis,
trichinellosis, and malignant edema.
Acute myositis is characterized by hot,
painful, edematous muscles of the affected
area. It occurs in black quarter caused by
Clostridium chauvei infection and characterized
by hot painful swelling which later converts
into cold, painless and emphysematous. The
other signs are fever, toxemia and sudden
death. In malignant edema, the infection gets
entry through wounds which causes soft,
doughy swelling, muscle becomes tense and
emphysematous, dark and are tightly
stretched.
Suppurative myositis is caused by pyogenic
bacteria which gets entry through trauma,
bruising and are responsible for pus
formation, swelling and pain in the affected
muscles.
Chronic myositis is characterized by
enlarged and firm muscles. It occurs in
actinobacillosis and actinomycosis.
Eosinophilic myositis is not common in
domestic animals; it affects the muscles of
mastication and characterized by edema of
muscles with eosinophilia in dogs.
Parasitic myositis is caused by Trichinella
spiralis and Sarcosporidia. In Trichinellosis, it
is characterized by the involvement of diaphragmatic, intercostal and tongue muscles.
These muscles are penetrated by larvae of
parasite, and forms cysts parallel to muscle
fibers causing granular degeneration of
sarcoplasm. In sarcosporidiosis, the lameness,
weakness, paralysis and emaciation may occur
due to affections of skeletal muscles of
animals.
Traumatic myositis may occur in the
muscles of limbs leading to pain, lameness,
swelling, fever and toxemia. Extreme exertion
due to running may cause myositis in animals,

52 Textbook of Veterinary Clinical and Laboratory Diagnosis

which may occur due to rupture of muscle.
In cows, the abductor muscle of thigh is more
prone to this type of myositis. Besides, during
parturient paresis, the gastrocnemious muscle
may rupture leading to myositis.
Muscular Hypertrophy
This condition is rare in dairy cattle; however, may occur in beef animals due to genetic
predisposition. Hypertrophy of muscles may
lead to dystocia, particularly when hind
quarter muscles are involved.
EXAMINATION OF BONES
Clinical examination of bones includes inspection and palpation, which may reveal the
alteration in consistency of bones. The
superficial bones can be palpated easily. The
structural alterations in bones may lead to
change in posture and gait of animal.
However, radiological examination is more
important in the diagnosis of bone diseases.
Osteodystrophy
It is the degeneration of bones caused due
to nutritional deficiency, toxic factors and
hereditary influences. The nutritional imbalance of calcium, phosphorus and vitamin
D may cause osteodystrophia fibrosa, rickets
and osteomalacia in animals.
Osteodystrophia Fibrosa
It is a nutritional deficiency disease of bones,
occurs mainly in horses. However, pigs and
dogs do suffer due to osteodystrophia
fibrosa. In horses, the soft fibrous tissues are
deposited in bones, mainly in the bones of
mandible with bilateral enlargement of facial
bones. This condition occurs due to primary
or secondary deficiency of calcium arising
from excessive dietary phosphorus, which is
due to heavy feeding of bran and cereals.

Hence, it is also known as bran disease or

big head or millers disease. Since bran
is a cheap by product, the horses of millers
are maintained on bran which contains high
levels of phosphorus. This phosphorus
combines with dietary calcium and forms
insoluble calcium phosphates in the intestines.
The calcium phosphate is not absorbed
through intestines and excreted out with
feces. Therefore, the sufficient amount of
calcium and phosphorus are not available in
blood.
In pigs, this condition occurs when they
are fed on garbage. The affected pigs show
bending of limb bones, lameness, change in
nasal bones and stenosis of respiratory
passage which is responsible for snoring
sounds. In dogs, softening of mandible and
maxilla with other bones of head lead to a
state rubber jaw. It may occur due to
hyperparathyroidism and chronic renal
insufficiency.
Osteoporosis may occur in animals and
birds due to reduction in bony matrix. The
bones may become porous and brittle. This
condition has been observed due to senility,
lack of protein in diet, deficiency of vitamin
A and C, pressure on bones and in
hyperthyroidism.
Rickets
Rickets occurs in calves grazing on phosphorus deficient land. The cereals and
fodders grown in such soils are also deficient
in phosphorus. In some calves housed for
longer periods, vitamin D deficiency may also
occur. The teeth or bones become abnormal
due to poor mineralization. The clinical picture
is enlargement of limb joints and costochondral junction. In severe cases, the bones
of jaws are also affected and prevent the
closure of jaws. Curvature of long bones of
forelimbs may occur (Fig. 8.1). The serum of

Examination of Musculoskeletal System

such animals is deficient in inorganic
phosphorus and there is increased level of
alkaline phosphatase observed in serum.

53

severe cases bone deformities have been

recorded. The blood level of phosphorus is
decreased while alkaline phosphatase level
is increased and radiological examination
reveals the lesions of osteoporotic bones. In
sows, osteomalacia occurs after 30-40 days
of furrowing and characterized by inability
to stand on hindlegs, fracture of demineralized bone and weakness.
Osteomyelitis

Fig. 8.1: Rickets in a calf

In pigs, increased thickness of bones at

epiphyseal cartilage and curvature of long
bones with lameness has been observed in
rickets. Dogs exhibit bending of limbs,
enlargement of joints and enlargement of ribs
at costochondral junction.
Osteomalacia
Osteomalacia occurs in cattle, in such areas
where soil is deficient in phosphorus. It is
manifested by demineralization of bones
leading to deformity and weak bones,
uncalcified diaphyseal osteoid, reduced
appetite, reduced productivity, painful stiff
gait and crackling joint sound on walking. In

Osteomyelitis is the inflammation of bone and

medullary cavity of bones. In long bones, it
is the cause of pain, lameness and swelling.
Osteomyelitis is caused by trauma, joint ill
in neonatal, calves, foals and lambs,
actinomycosis in cattle, brucellosis and
atrophic rhinitis in pigs and tuberculosis in
horse, cattle, pig and cat.
Actinomyces bovis produces granulomatous
lesions leading to initially painless bony
swelling on mandible or maxillae but later it
rapidly develops into a painful swelling with
breaking of the lesion, discharge of sticky
honey like fluid containing minute hard,
yellow-white granules through several
openings.
Brucella induced osteomyelitis occurs in
breeding pigs (boars), where the genital tract
is mainly involved. It is characterized by
gradual onset of lameness, incoordination and
posterior paralysis may occur due to
osteomyelitis of lumbar and sacral vertebrae
and inflammation of their joints. The lesions
of atrophic rhinitis are restricted to nasal
cavity; cause of which is not certain.
However, the Pasteurella multocida and
Bordettella bronchiseptica are found to be
associated with the disease. In this condition
the mucous membranes become atrophic and
decalcification and atrophy of turbinate and
ethmoid bone occur which is characterized
by sneezing, dyspnea, cyanosis and deformity of face. Atrophic rhinitis is also found

54 Textbook of Veterinary Clinical and Laboratory Diagnosis

to be associated with calcium deficiency in
diet.
Tuberculous osteomyelitis is observed in
horses, cattle, pigs, etc. in which the cervical
vertebrae are mainly involved. The
osteomyelitis is manifested by rarefaction of
calcium, stiffness of neck and unability of
animal to feed off the ground. If it is
associated with pulmonary lesions, coughing
occurs alongwith enlargement of regional
lymph nodes and a fluctuating temperature.
In such animals, the tuberculin test is positive.
In cattle and pigs, tuberculous osteomyelitis
occurs with tuberculous meningitis involving
vertebrae and meninges. The other causes of
osteomyelitis may be the tick pyemia in sheep,
inflammation from castration and docking
wounds in lambs which should be differentiated by history, clinical signs of edema and
discharging pus and leukocytosis.
Osteochondritis
Osteochondritis is aseptic necrosis of the bone
and its associated cartilage and is caused by
trauma. It mainly affects the epiphyseal cartilage resulting in avascular necrosis, congestion of surrounding bony tissue, osteoporosis
and resorption for necrosed bone. Clinically,
it is characterized by lameness, hard swelling
at epiphyseal cartilage of radius and metacarpal bone in horses and dogs. On radiological examination, the compression and
thinning of cartilage is observed.
Osteopetrosis
The shaft of long bones become thick and
hard resembling marble and thus the
condition is also known as marble bone
disease in poultry. It is caused by a RNA
virus of leukosis group belonging to family
retroviridae. New bones are formed from the
connective tissue of the periosteum and
endosteum. Due to the thickening of cortex,

the marrow cavity becomes narrow and

sometimes may become completely obliterated, the condition is called osteosclerosis.
Clinically, this condition is characterized by
anemia due to reduced hemopoesis.
Tumors of Bones
The primary tumors of the bones are
osteosarcoma and chondrosarcoma. The long
bones and ribs are mainly affected due to
neoplasms and it is characterized by painful
locomotion, difficulty in breathing and
outward growth of bony tissue. Metastatic
melanoma and squamous cell carcinoma
affecting bones may also occur in dogs.
EXAMINATION OF JOINTS
Clinically the joints are examined through
inspection and palpation. The terminology
used for the affections of joints is as follows:
1. Arthritis: Arthritis is the inflammation of
joint.
2. Coxitis: It is the inflammation of the hip
joint.
3. Gonitis: Gonitis is the inflammation of
stifle joint.
4. Bursitis: Bursitis is the inflammation of
bursa over the joints.
5. Hygroma: It is the involvement of carpal
joint in cattle.
6. Capped elbow: It is the swelling and
painful condition of hock joint of horses.
7. Poll evil: Poll evil is the inflammation of
the bursa between ligamentum nuchae
and atlas and axis.
8. Fistulus withers: It is the affections of
bursa between the ligamentum nuchae
and thoracic spines. Fistulus opens on
skin surface due to suppurative
granulomatous inflammation.
9. Spavin: It is arthropathy of the tarsal
joint affecting its medial and distal parts
causing ankylosis.

Examination of Musculoskeletal System

10. Ringbone: It is the degenerative arthropathy affecting interphalangeal articulation of horses resulting in ankylosis and
lameness. Articular ends of the bones
are joined together by granulation
tissue, which later calcifies giving a ring
appearance.
11. Ankylosis: Ankylosis is the immobility
and consolidation of a joint due to disease, injury and/or surgical procedure.
12. Arthropathy: Arthropathy is a degenerative disease condition of joints which
is non-inflammatory. However, the term
is used for any disease condition
involving the joints.
13. Arthrophyte: Arthrophyte is the abnormal growth in a joint cavity.
14. Sinovitis: It is the inflammation of the
synovial membrane of a joint.
15. Arthralgia: Arthralgia is the pain in joints.

55

Salmonella and E. coli infections. Infectious

polyarthritis has been found to occur in all
animals due to Chlamydia and/or Mycoplasma
sp. Arthritis is manifested by hot and painful
swelling around the joint leading to lameness.
The swelling is severe in pyogenic infections
of joints (Fig. 8.2). Enlargement of epiphyses
and extensive destruction of articular cartilage
is characterized by crepitation on movement
of joint. Most commonly affected joints are
hock, stifle, carpus while the fetlock,
interpharyngeal and intervertebral joints are
less commonly affected. The confirmation of
joint disease can be made by examination of
synovial fluid as described in Chapter 21.
Various types of arthritis occurs in animals
are as under.

Degenerative and Inflammatory

Disorders of Joints
Infectious Arthritis
Arthritis is the inflammation of joints involving synovial membrane and articular
cartilage. It may occur due to local injury or
trauma which facilitates the invasion of
bacteria. In calves, the infection may extend
from surrounding tissue giving rise to joint
ill, pyosepticemia, omphalophlebitis and foot
rot in cattle. The infectious cause of arthritis
includes E.coli, Streptococcus, Mycoplasma sp.
and Chlamydia sp. in animals. In foals, the involvement of Shigella equiralis and Salmonella
sp. has been observed. Actinomyces pyogenes,
Staphylococci, and Spherophorus necrophorus are
isolated from the joint infections of calves.
However, in lambs E. coli, Staphylococci and
Streptococci are the main cause of suppurative
arthritis. In dogs, the arthritis caused by
Staphylococci, Streptococci and Brucella abortus,
while in pigs it is associated with Brucella suis,

Fig. 8.2: Enlargement of knee joint due to

accumulation of inflammatory exudate

Rheumatoid Arthritis
Rheumatoid arthritis is manifested by severe
polyarthritis with swollen, painful joints,
fever and neutrophilia. This is more common
in dogs and its etiology is not fully
understood.
However, the presence of a rheumatoid
factor in blood has been found to be

56 Textbook of Veterinary Clinical and Laboratory Diagnosis

associated with arthritis. In some cases it is
associated with systemic lupus erythematous.
On radiological examination of joint, saw
tooth image is seen at the joint surface due
to erosive lesions on articular surface.
A similar condition has been observed in
cats which is characterized by edema of joints
(carpal and tarsal joints), fever, lymphadenopathy, neutrophilia and lymphocytosis. The
synovial fluid is turbid and yellowish having
numerous neutrophils and lymphocytes and
a syncitial virus has been found to be
associated with the condition. In this type of
arthropathy, the glomerulonephritis is
variably associated indicating to be an
immune complex mediated arthritis.
Navicular Disease
This is the terminal stage of arthritis and
bursitis involving distal sesamoid or navicular bone in horses. Erosion and ulceration of articular cartilage leads to inflammation and edema and bone becomes more
prone to disintegrate.
Manchester Wasting Disease
Manchester wasting disease is characterized
by calcification of arterial and other tissues
alongwith degenerative arthritis of limb
joints, calcification of tendons and ligaments.
This condition occurs in cattle and sheep due
to excessive vitamin D or calcium in diet
leading to hypercalcemia. The joints of
forelimbs become stiff and animal is unable
to walk or put weight on knees. Blood
calcium level is found to be increased.
Besides, degenerative arthropathy in
horses is seen which is usually associated with
deficiency of calcium, phosphorus, vitamin D
and copper. In cattle, the degenerative arthropathy is associated with high phosphorus
levels in feed involving hip or stifle joint and
occurs bilaterally. In pigs, chronic zinc

poisoning is associated with degenerative

lesions on articular surface of the head of
humerus.
Ankylosing spondylitis of vertebral
bodies in older dogs is characterized by pain,
disability, lameness and permanent stiffness
of the joints.
The affections of joints, besides clinical
examination, are diagnosed by the examination of synovial fluid. The details of the
collection, preservation and examination of
synovial fluid is given in Chapter 21.
QUESTIONS
Q 1. Indicate whether the following statements are True or False.
1. _______ The term myopathy is used for
necrosis of muscles.
2. _______ Absence of limbs is called Apodia.
3. _______ In azoturia, the urine becomes dark
brown in colour due to presence of
myoglobin.
4. _______ Equine myoglobinuria is characterized by increase in SGOT value to
1000 units per ml serum and hyper
kalemia.
5. _______ In Black Quarter disease in cattle,
there is acute myositis characterized by
painful and edematous swelling of the
affected muscles with presence of gas.
6. ________ Rickets in adults animals is a
deficiency disease.
________
7.
Brain disease or Millers
disease in horses is also known as
osteodystrophia fibrosa.
8. _________ Osteomalacia is also known as
adult rickets.
9. _______ Degenerative and non-inflammatory condition of joints is called
arthropathy.
10. ________ Vitamin C helps in the absorption
and utilization of calcium and phosphorus for bone growth and development.

Examination of Musculoskeletal System

Q 2. Fill in the spaces below with most
appropriate word/words.
1. Absence of anterior limb is known as
___________
.
2. Swelling and painful condition of hock
joint in horses is called___________.
3. Hump back condition in animals is
known as___________.
4. Black Quarter in cattle is caused
by___________.
5. The condition of bones becoming porous
and brittle is known as ___________.
6. Osteoblast cells form the matrix of the
bone called ___________.
7. Multinucleated phagocytic cells in bones
are called _______.
8. The immobility and consolidation of a
joint due to any disease or injury is
known as __________.
9. In _________ shaft of long bones become thick
and hard resembling marble and the
condition is known as marble bone
disease in poultry.
10. The inflammation of the bursa between
ligamentum nuchae, atlas and axis is
known as ________.
Q 3. Select the most appropriate answer
from the four choices given in each
question.
1. White muscle disease in calves occurs
due to deficiency of:
A. Vitamin A

57

B. Vitamin C
C. Vitamin E
D. Vitamin D
2. Inflammation of bone marrow is known
as:
A. Osteitis
B. Osteomyelitis
C. Myelitis
D. Spondylitis
3. Inflammation of hip joint is called:
A. Coxitis
B. Gonitis
C. Arthritis
D. Bursitis
4. Osteodystrophia fibrosa in horses occurs
due to excessive feeding of:
A. Phosphorus in diet
B. Calcium in diet
C. Vitamin D in diet
D. Magnesium in diet
5. Vitamins that helps and favours the
growth of bone is:
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin A, C and D
Q
1.
2.
3.
4.
5.

4. Define the following terms.

Lordosis
Micromelia
Hygroma
Fistulus withers
Rheumatoid arthritis