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BT but moderate impingement from the supraspinatus tendon, resulting in a secondary bicipital tenosynovitis. Cases 2 and 3 illustrated a normal shoulder joint except for tenosynovitis secondary to pathology of the BT, which demonstrated macroscopic

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the clinical and pathologic findings in dogs with primary bicipital tenosynovitis.

Animals—19 dogs with 20 shoulder joints treated surgically for bicipital tenosynovitis and 8 shoulder joints from 4 clinically normal dogs.

Procedure—Histologic abnormalities of tendon sheaths of the biceps brachii in affected dogs were determined by use of comparison with findings in clinically normal dogs. Specimens were graded for inflammation, fibrosis, villous hypertrophy, vascular prominence, and synovial cell proliferation. Histopathologic results were statistically evaluated for relationship with clinical findings and treatment before surgery.

Results—Synovial villous hypertrophy and vascular prominence were the most consistent histologic findings in 16 and 14 of 20 affected joints, respectively. Evidence of inflammation was lacking in 6 joints. Ten joints had inflammatory cell infiltration of the tendon sheath. Plasma cells and lymphocytes were the most common infiltrates; however, the type and amount of inflammatory cell infiltrate were variable. Fibrosis of the tendon sheath was seen in 8 joints, and synovial cell proliferation was seen in 11 joints. Other changes included accumulation of hemosiderin, focal calcification, osseous metaplasia, lysis of collagen, and fibrocartilaginous metaplasia. No significant relationship was detected between histopathologic findings and clinical findings or treatment before surgery.

Conclusions and Clinical Relevance—Inflammation was more variable than hypothesized and may not be a consistent pathophysiologic feature of bicipital tenosynovitis. In some dogs, this disease may be the result of a degenerative process rather than an inflammatory process. (Am J Vet Res 2002;63:402–407)

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in American Journal of Veterinary Research

Summary

Medical records of 23 dogs with unilateral and 3 dogs with bilateral chronic bicipital tenosynovitis were reviewed. Mean age of affected dogs was 4.6 years (SD, 2.0 years), and mean body weight was 32.6 kg (SD, 14.5 kg). Neither a breed nor a gender predilection was detected. All dogs had a history of intermittent or progressive weight-bearing lameness that became worse after exercise. Mean duration of lameness prior to medical or surgical treatment was 6.5 months (range, 0.25 to 24 months), in all dogs, signs of pain were evident during palpation of the biceps tendon within the intertubercular groove. Radiography revealed sclerosis or osteophytosis of the intertubercular groove in all 29 shoulder joints. Mild degenerative joint disease was evident rudiographicully in 17. Arthrography was performed in 12 joints, and in 11 there were irregularities of or filling defects along the biceps tendon. Arthrocentesis was performed on 17 joints; 14 synovial fluid samples had cytologic abnormalities consistent with degenerative joint disease.

Medical treatment, consisting of injection of methylprcdnisolone acetate into the biceps tendon and its synovial sheath, was attempted in 21 of the 29 affected shoulder joints. Surgery, which consisted of tenodesis of the biceps tendon, was attempted in 14 joints; S of these had not been treated medically; the remaining 6 had poor results following medical treatment.

Gross and histologic findings consistent with chrome bicipital tenosynovitis were observed in all 14 joints in which surgery was performed. Seventeen of the medically treated shoulders were available for clinical evaluation, and results were excellent or good in 7. Twelve of the surgically treated shoulders were available for clinical re-evaluation, and results were excellent or good in all 12 (mean duration of follow-up, 5.7 months; range, 2 to 13 months). Owners of all dogs were contacted by telephone. Owners reported that results were excellent or good in 1.0 of the 21 medically treated shoulder joints, and in ail 14 of the, surgically treated shoulder joints (mean duration of follow-up, 30.1 months; range, 4 to 82 months).

Complications developed in 3 of the 4 dogs in which an osteotomy of the greater tubercle had been performed (implant migration, 2 dogs; delayed union, 1 dog). A seroma developed in 1 of the 10 dogs in which tenodesis was performed by laterally transposing the biceps tendon through a hole in the greater tubercle. Complications related to medical treatment were not detected.

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in Journal of the American Veterinary Medical Association
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The “ P value < .05” trope Thank you for publishing the article, “Synthesis of surgeon and rehabilitation therapist treatment methods of bicipital tenosynovitis in dogs allows development of an initial consensus therapeutic protocol.” 1 It

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in Journal of the American Veterinary Medical Association

R . Arthroscopic biceps brachii tenotomy as a treatment for canine bicipital tenosynovitis . J Am Anim Hosp Assoc 2002 ; 38 : 169 – 175 . 10.5326/0380169 3. Good CR Shindle MK Kelly BT , et al. Glenohumeral chondrolysis after

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in Journal of the American Veterinary Medical Association

surgical treatment of humeral osteitis and bicipital tenosynovitis in a horse . J Am Vet Med Assoc 1992 ; 201 : 305 – 306 . 5 Pugh CR Johnson PJ Crawley G , et al . Ultrasonography of the equine bicipital tendon region: a case

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in Journal of the American Veterinary Medical Association