Septic inflammation of the bicipital bursa: clinical, imaging, and surgical findings in nine horses.

The research is about the investigation and approach to handling cases of septic bicipital bursitis in nine horses. Different diagnostic techniques were employed and therapies tried to understand the most effective way to treat this condition.

Etiologies, Findings and Diagnostic Modalities

• The study reviewed medical records of horses diagnosed with septic bicipital bursitis between 2000 and 2021. The conditions for inclusion were complicated, including a high total nucleated cell count and neutrophil proportion, a high total protein concentration, and the presence of bacteria on cytology or positive synovial fluid culture.
• Trauma was identified as the most common cause of the condition. This indicates that physical injuries can significantly contribute to the development of septic bicipital bursitis in horses.
• Various diagnostic modalities were employed, including synthrocentesis using ultrasonographic guidance for all cases. This had implications on a cellular level, showing alterations consistent with septic synovitis.
• Radiography and ultrasonography were also used for diagnosis. While radiography identified pathology in 5 out of 9 horses, ultrasonography identified problems in all the horses, making it the most effective imaging modality.

Treatment and Outcome

• The treatment included bursoscopy, needle lavage, bursotomy, or pure medical management — the selection dependent on the condition’s severity and progress. However, bursoscopy, especially under standing sedation, was considered a feasible treatment option.
• Five out of the nine horses survived to discharge, indicating a survival rate of approximately 55.6%. Long-term follow-up was possible for three of these horses, all of whom regained sound health with two in training and one continuing retirement.
• The research concluded that horses treated for bicipital septic bursitis have a reasonable prognosis for survival. They could return to some level of athletic performance post-treatment, but prognosis must be viewed within each case’s individual context.

Significance of Ultrasonography

• The study emphasized the role of ultrasonography as vital in obtaining synovial fluid samples for the diagnosis of septic bicipital bursitis in horses. Its ability to detect pathology in all nine horses highlighted its effectiveness over other diagnostic modalities like radiography.