Endoscopic treatment of suspected infectious intertubercular bursitis in a horse.

The research article describes a case study of a 9-year-old horse, which was diagnosed and treated through endoscopy for an infection in its intertubercular bursa – a small fluid-filled sac located at the upper portion of its left forelimb.

Background

• The horse, a gelding, was first taken to the hospital due to a month-long period of mild, intermittent lameness in its left forelimb.
• During this first visit, atrophy (weakening) in the muscles of the upper part of the forelimb was observed. However, the veterinarians were unable to identify the precise cause of the lameness, and the horse was discharged.

Reevaluation and Diagnosis

• After 6 weeks, the horse was brought in again as the lameness had worsened. Now, the horse would oppose motion in the left shoulder joint.
• An aspirate, or fluid sample, from the intertubercular bursa was obtained using ultrasound guidance. Evaluation of this aspirate led to a suspicion of an infection.
• An endoscopic examination of the bicipital bursa (another term for intertubercular bursa), allowed for a comprehensive look at the bursa. This further confirmed the suspected infection by revealing an enlarged synovium, particularly in the distal part of the bursa. Synovium is a soft tissue found within bursae and joints that produces fluid for lubrication.

Treatment and Recovery

• A procedure called lavage was used to clean out the bursa. Moreover, a synovial resector was used to remove the inflamed synovial tissue.
• This treatment proved successful as the horse was healthy and recovered within four months post-treatment.

Significance

• The case illustrates that endoscopy can be an effective method for diagnosing and treating suspected infections in the intertubercular bursa in horses.
• The procedure allowed for both, comprehensive examination and effective treatment of the affected bursa, and was not technically challenging to perform.