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Topic:Equine Health

Equine health encompasses the study and management of diseases, disorders, and overall well-being of horses. It involves understanding various physiological systems, preventive care, and treatment strategies to maintain optimal health in equine populations. Common areas of focus include nutrition, infectious diseases, orthopedic conditions, and reproductive health. Research in equine health aims to advance knowledge on diagnostic methods, therapeutic interventions, and management practices that improve horse welfare and performance. This page collects peer-reviewed research studies and scholarly articles that explore the diverse aspects of equine health, offering insights into current findings and advancements in the field.
Expression of high-molecular-mass neurofilament protein in horse (Equus caballus) spinal ganglion neurons.
Microscopy research and technique    October 28, 2011   Volume 75, Issue 5 626-637 doi: 10.1002/jemt.21102
Russo D, Castellani G, Chiocchetti R.Spinal ganglion (SG) neurons are subdivided, on the basis of their cytoplasmic aspect at light and electron microscopy, into dark (D) and light (L) neurons. Numerous efforts have been made to find specific markers able to identify D and L neuronal cytotypes. The isolectin B4 (IB4), utilized to identify nonpeptidergic D neurons in mice, unfortunately, has not proved as effective in other species. The 200-kDa neurofilament protein (NF200) is considered as a typical marker of L neurons in the rat, cat, and chick. The aim of this study was to analyze the histological, morphometric, and neurochemic...
Basal glucose metabolism and peripheral insulin sensitivity in equine pituitary pars intermedia dysfunction.
The veterinary quarterly    October 28, 2011   Volume 31, Issue 1 19-28 doi: 10.1080/01652176.2011.570127
Klinkhamer K, Menheere PP, van der Kolk JH.Glucocorticoids are suggested to precipitate laminitis and induce insulin resistance in horses. Objective: To assess insulin sensitivity and the basal amount of glucose metabolized in equine pituitary pars intermedia dysfunction (PPID). Methods: The euglycaemic hyperinsulinaemic clamp (EHC) technique was performed in seven horses with a diagnosis of PPID based on the presence of hypertrichosis and positive dexamethasone suppression-test results comprising one gelding and six mares with a mean age of 21.1 ± 5.8 (SD; range 15-34) years. Results were compared with those from five negative (h...
Rhodococcus equi pneumonia in the foal–part 2: diagnostics, treatment and disease management.
Veterinary journal (London, England : 1997)    October 28, 2011   Volume 192, Issue 1 27-33 doi: 10.1016/j.tvjl.2011.08.009
Muscatello G.Various challenges face clinicians and farm managers in diagnosing, treating and preventing Rhodococcus equi pneumonia. The use of ultrasound imaging has aided in the early diagnosis of the disease, reducing treatment duration and improving therapeutic outcomes. Antimicrobial resistance in R. equi is an emerging issue that necessitates prudent antimicrobial therapy of diseased foals. Alternative methods of disease transmission, such as contagious foal-to-foal aerosol transmission, may need to be addressed to complement dust reduction environmental strategies and to minimise the overall risk of...
Protective effects of passively transferred merozoite-specific antibodies against Theileria equi in horses with severe combined immunodeficiency.
Clinical and vaccine immunology : CVI    October 28, 2011   Volume 19, Issue 1 100-104 doi: 10.1128/CVI.05301-11
Mealey RH, Kappmeyer LS, Ueti MW, Wagner B, Knowles DP.Theileria equi immune plasma was infused into young horses (foals) with severe combined immunodeficiency. Although all foals became infected following intravenous challenge with homologous T. equi merozoite stabilate, delayed time to peak parasitemia occurred. Protective effects were associated with a predominance of passively transferred merozoite-specific IgG3.
Pain recognition and treatment in the horse: a survey of equine veterinarians in The Netherlands and Belgium.
Tijdschrift voor diergeneeskunde    October 27, 2011   Volume 136, Issue 10 715-724 
Dujardin CL, van Loon JP.This survey investigated the attitudes of equine veterinarians in The Netherlands and the Flemish region of Belgium towards pain management in the horse. Questionnaires were sent out to 771 equine veterinarians, all members of the Dutch or Flemish equine practitioners society. The return rate of completed questionnaires was 16.6%. The survey provided information about the use of analgesic drugs, factors influencing their prescription, pain scoring, analgesic therapy for specific clinical conditions, use of epidural analgesia, and appraisal of personal knowledge of pain management. The pain sco...
Web-based documentation of clinical skills to assess the competency of veterinary students.
Journal of veterinary medical education    October 26, 2011   Volume 38, Issue 3 242-250 doi: 10.3138/jvme.38.3.242
Rush BR, Biller DS, Davis EG, Higginbotham ML, Klocke E, Miesner MD, Rankin DC.Kansas State University implemented a Web-based program to assess students' competency to perform technical skills during clinical rotations throughout the fourth year of the veterinary curriculum. The classes of 2009 and 2010 recorded a minimum number of procedures (104 and 103, respectively) from a menu of more than 220 recommended procedures. Procedures were categorized by species (small animal, equine, food animal) and disciplines (imaging, anesthesia, diagnostic medicine/necropsy). Ophthalmology was added as a fourth discipline for the class of 2010. Students recorded procedures into the ...
Voluntary ingestion of wood shavings by obese horses under dietary restriction.
The British journal of nutrition    October 26, 2011   Volume 106 Suppl 1 S178-S182 doi: 10.1017/S0007114511000547
Curtis GC, Barfoot CF, Dugdale AH, Harris PA, Argo CM.Dietary restriction for the weight-loss management of obese horses limits the natural trickle-feeding behaviour. During feed restriction, wood shavings are often advised as bedding to prevent dietary supplementation from non-feed sources. Data from twelve overweight/obese horses and ponies of mixed breed and sex, bedded on wood shavings during 16 weeks of feed restriction, were retrospectively evaluated. DM intake (DMI) was restricted to 1.25 % of body mass (BM) daily. Animals were randomly assigned to one of two diets (hay/chaff, n 6; hay/balancer meal, n 6). BM was recorded weekly. Feeding b...
Comparison of plasma and peritoneal indices of fibrinolysis between foals and adult horses with and without colic.
American journal of veterinary research    October 26, 2011   Volume 72, Issue 11 1535-1540 doi: 10.2460/ajvr.72.11.1535
Watts AE, Fubini SL, Todhunter RJ, Brooks MB.To identify hemostatic imbalances indicative of an increased risk of intra-abdominal adhesion formation in foals versus adult horses. Methods: Horses with colic undergoing exploratory laparotomy or abdominocentesis as part of a clinical examination (n = 16 foals ≤ 6 months of age and 19 adults ≥ 5 years of age) and horses without colic undergoing herniorrhaphy (15 foals) or euthanasia for noninflammatory and nongastrointestinal disease (10 foals and 20 adults). Methods: Paired abdominal fluid and blood samples were collected from each horse into buffered sodium citrate and centrifuged imme...
Effects of in vivo lidocaine administration at the time of ischemia and reperfusion on in vitro contractility of equine jejunal smooth muscle.
American journal of veterinary research    October 26, 2011   Volume 72, Issue 11 1449-1455 doi: 10.2460/ajvr.72.11.1449
Guschlbauer M, Feige K, Geburek F, Hoppe S, Hopster K, Pröpsting MJ, Huber K.To determine whether administration of lidocaine during ischemia and reperfusion in horses results in concentrations in smooth muscle sufficient to protect against the negative consequences of ischemia-reperfusion injury on smooth muscle motility. Methods: 12 horses. Methods: Artificial ischemia and reperfusion injury of jejunal segments was induced in vivo in conjunction with lidocaine treatment during ischemia (IRL) or without lidocaine treatment (IR). Isometric force performance was measured in vitro in IRL and IR smooth muscle preparations with and without additional in vitro application o...
Inhibition of cytochrome P450 enzymes involved in ketamine metabolism by use of liver microsomes and specific cytochrome P450 enzymes from horses, dogs, and humans.
American journal of veterinary research    October 26, 2011   Volume 72, Issue 11 1505-1513 doi: 10.2460/ajvr.72.11.1505
Mössner LD, Schmitz A, Theurillat R, Thormann W, Mevissen M.To identify and characterize cytochrome P450 enzymes (CYPs) responsible for the metabolism of racemic ketamine in 3 mammalian species in vitro by use of chemical inhibitors and antibodies. Methods: Human, canine, and equine liver microsomes and human single CYP3A4 and CYP2C9 and their canine orthologs. Methods: Chemical inhibitors selective for human CYP enzymes and anti-CYP antibodies were incubated with racemic ketamine and liver microsomes or specific CYPs. Ketamine N-demethylation to norketamine was determined via enantioselective capillary electrophoresis. Results: The general CYP inhibit...
Genetic differences in the serum proteome of horses, donkeys and mules are detectable by protein profiling.
The British journal of nutrition    October 26, 2011   Volume 106 Suppl 1 S170-S173 doi: 10.1017/S0007114511000845
Henze A, Aumer F, Grabner A, Raila J, Schweigert FJ.Although horses and donkeys belong to the same genus, their genetic characteristics probably result in specific proteomes and post-translational modifications (PTM) of proteins. Since PTM can alter protein properties, specific PTM may contribute to species-specific characteristics. Therefore, the aim of the present study was to analyse differences in serum protein profiles of horses and donkeys as well as mules, which combine the genetic backgrounds of both species. Additionally, changes in PTM of the protein transthyretin (TTR) were analysed. Serum protein profiles of each species (five anima...
A case of Borrelia-associated cutaneous pseudolymphoma in a horse.
Veterinary dermatology    October 26, 2011   Volume 23, Issue 2 153-156 doi: 10.1111/j.1365-3164.2011.01013.x
Sears KP, Divers TJ, Neff RT, Miller WH, McDonough SP.This case report describes a 10-year-old horse that developed multiple dermal papules over the right masseter area following removal of a tick from the same site 3 months earlier. Histological examination of a biopsy from a papule was suggestive of either a T-cell-rich B-cell lymphoma or cutaneous lymphoid hyperplasia, a form of pseudolymphoma sometimes associated with a tick bite. Positive serological testing and PCR of the biopsy sample for Borrelia in conjunction with immunohistochemical testing of the skin biopsy, the clinical history and response to treatment with doxycycline strongly sup...
Functional characterization of EUL47 in productive replication, morphogenesis and infectivity of equine herpesvirus 1.
Virus research    October 26, 2011   Volume 163, Issue 1 310-319 doi: 10.1016/j.virusres.2011.10.021
Yu MH, Kasem S, Yoshizaki N, Pagamjav O, Yamaguchi T, Ohya K, Fukushi H.EUL47 is a major component of the tegument of equine herpesvirus 1 (EHV-1). To determine its function, we used Red/ET cloning to delete its gene (gene 13) from EHV-1 strain Ab4p inserted into a bacterial artificial chromosome (BAC), yielding Ab4pattBΔ13. We also examined the reverted virus (Ab4pattB13R). Ab4pattBΔ13 replicated in rabbit kidney (RK)-13 cells, indicating that ORF13 is dispensable for virus replication in cell culture. Its intracellular and extracellular titers were about 10- and 100-fold lower than those of the revertant and parent strains, respectively. In addition, the plaqu...
Evaluation of biomechanical effects of four stimulation devices placed on the hind feet of trotting horses.
American journal of veterinary research    October 26, 2011   Volume 72, Issue 11 1489-1495 doi: 10.2460/ajvr.72.11.1489
Clayton HM, Lavagnino M, Kaiser LJ, Stubbs NC.To compare effects of 4 types of stimulation devices attached to the hind feet on hoof flight, joint angles, and net joint powers of trotting horses. Methods: 8 clinically normal horses. Methods: Horses were evaluated under 5 conditions in random order: no stimulators, loose straps (10 g), lightweight tactile stimulators (55 g), limb weights (700 g), and limb weights with tactile stimulators (700 g). Reflective markers on the hind limbs were tracked during the swing phase of 6 trotting trials performed at consistent speed to determine peak hoof heights and flexion angles of the hip, stifle, ta...
Unilateral and bilateral laparoscopic ovariectomy in 157 mares: a retrospective multicenter study.
Veterinary surgery : VS    October 26, 2011   Volume 40, Issue 8 1009-1014 doi: 10.1111/j.1532-950X.2011.00884.x
Röcken M, Mosel G, Seyrek-Intas K, Seyrek-Intas D, Litzke F, Verver J, Rijkenhuizen AB.To evaluate surgical techniques, perioperative complications and outcome of laparoscopic surgery for unilateral and bilateral ovariectomy in mares. Methods: Retrospective multicenter case series. Methods: Mares (n = 157). Methods: Indications for surgery were neutering, fertility problems, elimination of hormone-related abnormal behavior, ovarian tumors as well as nonregressive ovarian hematomas or cysts. Ovariectomy (n = 206) were performed by a standard laparoscopic procedure in 157 standing sedated mares. Dissection and hemostasis were achieved by using either (1) a linear stapling device, ...
Effects of opsonization of Rhodococcus equi on bacterial viability and phagocyte activation.
American journal of veterinary research    October 26, 2011   Volume 72, Issue 11 1465-1475 doi: 10.2460/ajvr.72.11.1465
Dawson DR, Nydam DV, Price CT, Graham JE, Cynamon MH, Divers TJ, Felippe MJ.To investigate the effect of opsonization of Rhodococcus equi with R. equi-specific antibodies in plasma on bacterial viability and phagocyte activation in a cell culture model of infection. Methods: Neutrophils and monocyte-derived macrophages from 6 healthy 1-week-old foals and 1 adult horse. Methods: Foal and adult horse phagocytes were incubated with either opsonized or nonopsonized bacteria. Opsonization was achieved by use of plasma containing high or low concentrations of R. equi-specific antibodies. Phagocyte oxidative burst activity was measured by use of flow cytometry, and macrophag...
Radiographic evaluation of changes in the proximal phalanx of Thoroughbreds in race training.
American journal of veterinary research    October 26, 2011   Volume 72, Issue 11 1482-1488 doi: 10.2460/ajvr.72.11.1482
Beccati F, Pepe M, Di Meo A, Davanzo S, Moriconi F.To evaluate changes in the cortical bone of the proximal phalanx of the fore-limbs of Thoroughbreds in response to training. Methods: Twenty-seven 2-year-old Thoroughbreds (20 females, 2 males, and 5 geldings). Methods: Horses were principally in training for races in a straight line and in a clockwise direction. Lateromedial and dorsopalmar radiographic views of each metacarpophalangeal joint were obtained before the horses started training and 1 year after starting exercise and racing. Width of the dorsal, palmar, lateral, and medial cortex and the width and thickness of the medulla were mea...
Ex vivo spontaneous generation of 19-norandrostenedione and nandrolone detected in equine plasma and urine.
The Journal of steroid biochemistry and molecular biology    October 25, 2011   Volume 128, Issue 1-2 1-11 doi: 10.1016/j.jsbmb.2011.10.005
Guan F, Uboh CE, Soma LR, You Y, Li X, McDonnell S.19-Norandrostenedione (NAED) and nandrolone are anabolic-androgenic steroids (AASs). Nandrolone was regarded solely as a synthetic AAS until the 1980s when trace concentrations of apparently endogenous nandrolone were detected in urine samples obtained from intact male horses (stallions). Since then, its endogenous origin has been reported in boars and bulls; endogenous NAED and nandrolone have been identified in plasma and urine samples collected from stallions. More recently, however, it was suggested that NAED and nandrolone detected in urine samples from stallions are primarily artifacts d...
Evaluation of the usefulness of a PCR assay performed at a clinical laboratory for the diagnosis of respiratory disease induced by equine herpesvirus type 1 in the field.
Journal of equine science    October 25, 2011   Volume 22, Issue 3 53-56 doi: 10.1294/jes.22.53
Ohta M, Nemoto M, Tsujimura K, Kondo T, Matsumura T.A PCR assay for the diagnosis of respiratory disease induced by equine herpesvirus type 1 (EHV-1) was performed at the clinical laboratory in the Racehorse Clinic of the Ritto Training Center of the Japan Racing Association from December 2007 to March 2008. The assay was performed without the trouble of contamination throughout the study and its turnaround time was approximately 6 hr. The PCR detection rates of EHV-1 among seroconverted horses were 22.2% for nasal swabs and 33.3% for blood samples. However, EHV-1 DNA was also detected in horses without seroconversion at a low rate. These resul...
Effects of the insulin sensitizing drug, pioglitazone, and lipopolysaccharide administration on markers of systemic inflammation and clinical parameters in horses.
Veterinary immunology and immunopathology    October 25, 2011   Volume 145, Issue 1-2 42-49 doi: 10.1016/j.vetimm.2011.10.007
Wearn JG, Suagee JK, Crisman MV, Corl BA, Hulver MW, Hodgson DR, Geor RJ, McCutcheon LJ.Equine metabolic syndrome (EMS) is a condition of obese horses characterized by insulin resistance, systemic inflammation, and an increased risk of laminitis. The pathogenesis of EMS is thought, in part, to be due to inflammatory proteins produced by adipose tissue. Reducing inflammation may decrease the incidence of laminitis in horses with EMS. Pioglitazone hydrochloride, a thiazolidinedione, has efficacy to reduce obesity associated inflammation in humans. Eight normal, adult, horses were administered 1mg/kg pioglitazone for 14 days, and eight horses served as controls. Physical examination...
Injury induces a change in the functional characteristics of cells recovered from equine tendon.
Journal of equine science    October 25, 2011   Volume 22, Issue 3 57-60 doi: 10.1294/jes.22.57
Kihara R, Kasashima Y, Arai K, Miyamoto Y.Injury initiates a repair process characterized by influx of fibroblasts and the rapid formation of fibrous scar tissue and subsequent tissue contraction. The response to injury and behavior of the different tendon fibroblast populations, however, has been poorly characterized. We hypothesized that the fibroblasts recovered from tendon with acute injury would exhibit different cell properties relating to adhesion, migration and tensegrity. To test this hypothesis we evaluated the ability of fibroblasts recovered from normal and injured equine superficial digital flexor tendons (SDFTs). The inj...
Transfer of tumour necrosis factor-α via colostrum to foals.
The Veterinary record    October 25, 2011   Volume 170, Issue 2 51 doi: 10.1136/vr.100220
Secor EJ, Matychak MB, Felippe MJ.This study aimed to determine whether TNF-α is transferred to equine neonates via colostrum and the relationship between TNF-α and IgG concentrations in the equine neonate. Colostrum, presuckle and postsuckle foal serum samples were collected from healthy mares and their foals. Equine TNF-α ELISA and IgG SRID kits were used to determine the concentrations of TNF-α and IgG, respectively. Statistical analysis was performed using the Spearman rank correlation. TNF-α concentrations in all presuckle foal serum were below the limit of detection in 15/16 foals and increased in postsuckle foal se...
Equine pre-implantation conceptuses express neuraminidase 2–a potential mechanism for desialylation of the equine capsule.
Reproduction in domestic animals = Zuchthygiene    October 24, 2011   Volume 47, Issue 3 449-454 doi: 10.1111/j.1439-0531.2011.01901.x
Klein C, Troedsson M.During the second and third week of pregnancy, the equine conceptus is covered by an acellular glycoprotein capsule. This capsule contains glycoproteins resembling those of the mucin family with sialic acid making up a high proportion of the carbohydrate. Coinciding with conceptus fixation, a marked decline in sialic acid content of the capsule occurs, which has been proposed to contribute to cessation of conceptus mobility. Herein, we describe the expression of neuraminidase 2 (NEU2) by pre-implantation stages of equine conceptus development. NEU2 transcript abundance was examined in conceptu...
Axial speed of sound for the monitoring of injured equine tendons: a preliminary study.
Journal of biomechanics    October 22, 2011   Volume 45, Issue 1 53-58 doi: 10.1016/j.jbiomech.2011.10.016
Vergari C, Pourcelot P, Ravary-Plumioën B, Dupays AG, Jacquet S, Audigié F, Denoix JM, Laugier P, Mitton D, Crevier-Denoix N.Equine superficial digital flexor tendons (SDFT) are often injured, and they represent an excellent model for human sport tendinopathies. While lesions can be precisely diagnosed by clinical evaluation and ultrasonography, a prognosis is often difficult to establish; the knowledge of the injured tendon's mechanical properties would help in anticipating the outcome. The objectives of the present study were to compare the axial speed of sound (SOS) measured in vivo in normal and injured tendons and to investigate their relationship with the tendons' mechanical parameters, in order to assess the ...
Effect of dental correction on voluntary hay intake, apparent digestibility of feed and faecal particle size in horse.
Journal of animal physiology and animal nutrition    October 22, 2011   Volume 97, Issue 1 72-79 doi: 10.1111/j.1439-0396.2011.01244.x
Zwirglmaier S, Remler HP, Senckenberg E, Fritz J, Stelzer P, Kienzle E.In nine adult Warmblood horses with mild to moderate dental findings (no signs of discomfort during chewing), voluntary hay intake before and after dental correction was examined. In a second experiment, digestibility of feed and faecal particle size were determined (3 days of total faecal collection) before and after dental correction. During both digestion trials including a 3-day adaptation period, the amount of hay and concentrate (mixture of oats, barley and maize) was kept constant in each individual horse before and after dental correction. Voluntary hay intake in individual horses ra...
Persistent digital hyperthermia over a 48 h period does not induce laminitis in horses.
Veterinary journal (London, England : 1997)    October 22, 2011   Volume 192, Issue 3 435-440 doi: 10.1016/j.tvjl.2011.09.016
de Laat MA, Pollitt CC, Walsh DM, McGowan CM, Sillence MN.Persistent digital hyperthermia, presumably due to vasodilation, occurs during the developmental and acute stages of insulin-induced laminitis. The objectives of this study were to determine if persistent digital hyperthermia is the principal pathogenic mechanism responsible for the development of laminitis. The potent vasodilator, ATP-MgCl(2) was infused continuously into the distal phalanx of the left forefoot of six Standardbred racehorses for 48 h via intra-osseous infusion to promote persistent digital hyperthermia. The right forefoot was infused with saline solution and acted as an inter...
Molecular and cytogenetic studies in a case of XX SRY-negative sex reversal in an Arabian horse. Ciotola F, Albarella S, Pasolini MP, Auletta L, Esposito L, Iannuzzi L, Peretti V.An 18-month-old Arabian foal characterized by a stallion-like appearance was submitted for cytogenetic and molecular genetics examinations due to abnormalities of external genitalia and the presence of ovotestis-like structures in the abdominal cavity. By RB-banding the animal showed the normal female equine karyotype (2n = 64,XX). Molecular analysis revealed the absence of the SRY and ZFY genes and the presence of ZFX, a typical female equine condition. The entire RSPO1 coding region was examined to exclude its involvement. Although a SNP was found in exon 3, it was not responsible for an ami...
Expression patterns of intestinal calcium transport factors and ex-vivo absorption of calcium in horses.
BMC veterinary research    October 22, 2011   Volume 7 65 doi: 10.1186/1746-6148-7-65
Sprekeler N, Müller T, Kowalewski MP, Liesegang A, Boos A.In many species, the small intestine is the major site of calcium (Ca(2+)) absorption. The horse differs considerably from most other species with regard to the physiology of its Ca(2+) metabolism and digestion. Thus, this study was performed to get more information about the transcellular Ca(2+) absorption in the horse.Two mechanisms of intestinal Ca(2+) absorption are described: the passive paracellular pathway and the active, vitamin D-dependent transcellular pathway. The latter involves the following elements: vitamin D receptors (VDR), transient receptor potential vanilloid channel member...
Transcriptional analysis of equine λ-light chains in the horse breeds Rhenish-German Coldblood and Hanoverian Warmblood.
Veterinary immunology and immunopathology    October 21, 2011   Volume 145, Issue 1-2 50-65 doi: 10.1016/j.vetimm.2011.10.006
Hara S, Diesterbeck US, König S, Czerny CP.The present study analyzed equine λ-light chain genes (IGLV and IGLC) transcribed in the horse breeds Rhenish-German Coldblood (RGC) and Hanoverian Warmblood (HW). Primers were generated for the major expressed IGLV subgroup 8. The significant majority of the sequences represented IGLC6/7. In RGC, IGLC1 and IGLC5 were observed in significant higher frequencies than IGLC4. In HW, significant differences were obtained for the transcription of IGLC1 and IGLC5. IGLC4 was not determined in this breed. Five allotypic IGLC1 variants, four allotypic IGLC5 variants, and three allelic as well as two al...
Differentiation of ataxic and orthopedic gait abnormalities in the horse.
The Veterinary clinics of North America. Equine practice    October 21, 2011   Volume 27, Issue 3 411-416 doi: 10.1016/j.cveq.2011.08.007
Licka TF.The differentiation of ataxia and orthopedic disease can be facilitated by the use of several additional tests, not commonly part of either neurologic or orthopedic examination protocols. However, a full neurologic and orthopedic examination and suitable diagnostic imaging will of course also be necessary in such cases. The common association of orthopedic and neurologic disease makes it even more necessary to correctly attribute movement or posture abnormalities to potentially treatable structures.