Texas Equine Veterinary Association

www.teva-online.org • Page 10 tendonitis and/or bicipital bursitis, allowing time for the tendon to heal. 6 Bicipital bursa injections using hyaluronic acid and a corticosteroid can also be performed to reduce inflammation within bicipital bursa or biceps brachii tendon. Recently, biceps brachii intralesional stem cell therapy has been used with promising results. Bicipital bursa arthrocentesis should be performed in the presence of a wound that potentially communicates with the bicipital bursa or if septic bicipital bursitis is suspected. White blood cell count, total protein, and culture/sensitivity should be performed on the fluid obtained from the arthrocentesis. If sepsis is confirmed, lavage and/or arthroscopy of the bicipital bursa should be performed in addition to local and systemic antibiotic therapy. There are a few reports of intertubercular groove subchondral cysts that have been debrided via arthroscopy yielding good results. There have also been reports of intertubercular groove osteolytic lesions following sepsis of the biceps brachii tendon and bicipital bursa. In cases of intertubercular groove osteolysis, complete transection of the biceps brachii tendon and intertubercular groove debridement can be performed resulting in a fair prognosis for return to soundness. Prognosis is highly variable and too few cases have been reported to provide an accurate prognosis. In cases of simple biceps brachii tendonitis, the prognosis for return to function is good. However, when associated with bone abnormalities or sepsis, prognosis for return to soundness ranges from poor to good depending on structures involved, duration of the problem, and response to treatment. 6 concLusIon While shoulder lameness is quite uncommon, this is a fairly comprehensive review of pathology that can cause lameness. Performing the appropriate diagnostics and confirmation with intrasynovial anesthesia will help aid in determination of appropriate treatment options. RefeRences 1. Moyer W, Schumacher J, Schumacher J. A guide to equine joint injection and regional anesthesia. Veterinary Learning Systems, Yardley, PA. 2007. 2. Mez JC, Dabareiner RM, Cole RC, et al. Fractures of the greater tubercle of the humerus in horses (15 cases). J Am Vet Med Assoc 12:1878. 2000. 3. Dyson S. Interpreting radiographs. Radiology of the equine shoulder and elbow. Equine Vet J. 5:352. 1986. 4. Doyle PS, White NA. Diagnostic findings and prognosis following arthroscopic treatment of subtle osteochondral lesions in the shoulder joint of horses: 15 cases. J am Vet Med Assoc 12:1878. 2000. 5. McIlwraith CW, Nixon AJ, Wright IM, et al: Diagnostic and surgical arthroscopy of the scapulohumeral joint. In Boeining KJ (ed): Diagnositic and Surgical Arthroscopy in the horse. Mosby, Oxford, GB. 2005. 6. Fortier LA: Shoulder. In J Auer & J Stick (eds). Equine Surgery (1379-1387). St Louis, Mo. Elsevier. 7. Pankowski RL, Grant BD, Sande R, et al: Fracture of the supraglenoid tubercle. Treatment and results in five horses. Vet Surg 1:33. 1986. 8. Semevolos SA, Watkins JP, Auer JA. Scapulohumeral arthrodesis in miniature horses. Vet Surg 5:416. 2003. 9. Dutton DM, Honnas CM, Watkins JP. Nonsurgical treatment of supra-scapular nerve injury in horses: 8 cases. J Am Vet Med Assoc 11:1657. 1999. 10. Adams OR, Schneider RK, Bramlage LR, et al. A surgical approach to treatment of suprascapular nerve injury in the horse. J Am Vet Med Assoc. 10:1016. 1985. 11. Dyson SJ, Dik KJ. Miscellaneous conditions of tendons and tendon sheaths, and ligaments. Vet Clin North Am Equine Pract 2:315. 1995. Figure 8. Ultrasound of a normal biceps tendon (left, green arrows) and intertubercular groove (left, red arrows) in comparison to the ultrasound on the right showing effusion within the bicipital bursa (right, red arrows) and tendonitis of the biceps tendon (right, green arrows).

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