Endoscopic treatment of suspected infectious intertubercular bursitis in a horse

A 9-year-old gelding was evaluated because of a 30-day history of mild intermittent left forelimb lameness. The only detectable abnormality was mild atrophy of the musculature of the proximal portion of the left forelimb. The cause of the lameness could not be determined. The horse was discharged from the hospital, but was reexamined 6 weeks later because of worsening of the lameness. At that time, the horse resisted flexion and extension of the left shoulder joint, and results of evaluation of an ultrasound-guided aspirate of fluid from the intertubercular bursa were suggestive of infection. Endoscopic examination of the bicipital bursa revealed synovial hypertrophy, particularly in the distal aspect of the bursa. The bursa was lavaged, and a synovial resector was used to remove inflamed synovium. The horse recovered and was healthy 4 months later. In this horse, endoscopy allowed adequate examination of the intertubercular bursa and was not technically difficult.