Luna

Patient Name: Luna W 10/6/25 Luna has a diagnosis from Paragon referrals: Questionable evidence of bilateral hip dysplasia (with no radiographically apparent secondary changes) and mineralisation at the L7-S1 region of the spinal cord causing foraminal stenosis. Inguinal hernia. Subjective     During routine walking, no scuffing or toe dragging – 2x 20 minutes show the second walk is more fatiguing Able to sit, stand and lie well – very occasional lateral placement of the hindlimbs. Bunny Hopping gait observed at faster gaits Better outlook since receiving pain relief, O report paracetamol is observed to have best effects Objective: On examination she was walking with a shorter stride in the left hindlimb and a circumduction of the right hindlimb. Posture shows mildly rounded lumbar spine and pelvis held in flexion with reluctance to extend hips – this was much improved today with left hindlimb extension restricted in last 10% range and protraction limited by hamstring tension. Physical Examination Findings: Very mild lattissimus dorsi reactivity bilaterally. Reactivity of the right side lumbar musculature, and left rib heads. No crepitus seen in other joints today indicating weight bearing has improved. Bilaterally stifle extension was limited by excess hamstring tone and reactivity, more so left side today. Hip extension limited bilaterally. Good transitions from sit to stand – visible muscle weakness but no abnormal foot stance. Spinal range of motion was good. Plan o Strengthening exercises and stability work to re-establish correct weight bearing and muscle mass over the left hindlimb. Progress to using a cushion or slightly more challenging surface