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Disorders of the infraspinatus tendon and bursa in three horses

Mary Beth WhitcombDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Sarah S. le JeuneDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Melinda M. MacDonaldDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Larry D. GaluppoDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Carter E. JudyDepartment of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Abstract

Case Description—3 horses with penetrating wounds to the shoulder area were examined because of forelimb lameness.

Clinical Findings—All horses had physical examination findings (decreased cranial phase of the stride, swelling in the shoulder region, and signs of pain on manipulation of the shoulder) that were suggestive of problems in the upper portion of the forelimb. Injury to the biceps tendon or bursa was the primary differential diagnosis in each instance, but no abnormalities involving those structures were found. Radiographic and ultrasonographic imaging revealed injuries to the caudal eminence of the greater tubercle of the humerus, the infraspinatus tendon, and the infraspinatus bursa. Examination with ultrasound was more sensitive than radiography at detecting both osseous and soft tissue changes.

Treatment and Outcome—All 3 horses responded favorably to treatment with antimicrobials and non-steroidal anti-inflammatory drugs. Although initial response to standing lavage was favorable in 1 horse, endoscopic lavage was later required. Standing removal of fracture fragments was performed in 2 horses. Ultrasonographic imaging was helpful in monitoring the response to treatment and changes in the affected structures. All 3 horses eventually became sound after treatment.

Clinical Relevance—Infraspinatus bursitis and tendonitis should be included in the differential diagnoses of horses with shoulder lameness. Diagnosis and monitoring should include ultrasonographic monitoring. The prognosis for return to soundness after appropriate treatment appears to be good.

Abstract

Case Description—3 horses with penetrating wounds to the shoulder area were examined because of forelimb lameness.

Clinical Findings—All horses had physical examination findings (decreased cranial phase of the stride, swelling in the shoulder region, and signs of pain on manipulation of the shoulder) that were suggestive of problems in the upper portion of the forelimb. Injury to the biceps tendon or bursa was the primary differential diagnosis in each instance, but no abnormalities involving those structures were found. Radiographic and ultrasonographic imaging revealed injuries to the caudal eminence of the greater tubercle of the humerus, the infraspinatus tendon, and the infraspinatus bursa. Examination with ultrasound was more sensitive than radiography at detecting both osseous and soft tissue changes.

Treatment and Outcome—All 3 horses responded favorably to treatment with antimicrobials and non-steroidal anti-inflammatory drugs. Although initial response to standing lavage was favorable in 1 horse, endoscopic lavage was later required. Standing removal of fracture fragments was performed in 2 horses. Ultrasonographic imaging was helpful in monitoring the response to treatment and changes in the affected structures. All 3 horses eventually became sound after treatment.

Clinical Relevance—Infraspinatus bursitis and tendonitis should be included in the differential diagnoses of horses with shoulder lameness. Diagnosis and monitoring should include ultrasonographic monitoring. The prognosis for return to soundness after appropriate treatment appears to be good.

Contributor Notes

Dr. Judy's present address is Alamo Pintado Equine Medical Center, 2501 Santa Barbara Ave, Los Olivos, CA 93441.

Address correspondence to Dr. Whitcomb.