Supraspinous Bursa

The supraspinous bursa overlies the summits of the dorsal spinous process of the second to fifth thoracic vertebrae, under the funicular part of the nuchal ligament. Inflammation of the supraspinous bursa and surrounding soft tissues, so-called fistulous withers, is usually infectious in origin and may be a sequela to trauma. Streptococcus and Staphylococcus species, Brucella abortus, and Onchocerca cervicalis have been considered important causative agents.^1-3

Clinical signs of supraspinous bursitis are generalized soft tissue swelling, heat and pain, and often draining tract(s). Osteitis or osteomyelitis of the dorsal spinous processes of the cranial thoracic vertebrae may be concurrent. Care must be taken not to misinterpret the normal granular radiopaque appearance of normal, incompletely ossified summits of the dorsal spinous processes.⁴ Diagnostic ultrasonography and radiology are useful for determining the extent of the infection, for identifying a foreign body, and for evaluating signs of osteitis or osteomyelitis.

Treatment is by aggressive surgical debridement of all infected tissue and establishment of adequate drainage, taking care not to penetrate the dorsoscapular ligament. Several surgical procedures may be required to resolve the infection successfully.^1-3

Intertubercular (Bicipital) Bursa

The intertubercular (bicipital) bursa is discussed in Chapter 40.

Hygroma

Hygroma is discussed in Chapters 38 and 67.

Navicular Bursa

The navicular bursa is discussed in Chapters 24 and 30.

Trochanteric Bursa

The Editors have no clinical experience of trochanteric bursitis. This condition is discussed further in Chapter 47.

Calcaneal Bursa

The calcaneal or intertendonous bursa lies between the tendons of the gastrocnemius and the superficial digital flexor muscles, proximal to the hock, and extends distally on the plantar aspect of the calcaneus to the distal aspect of the hock (Figure 79-1). In most horses a communication exists between the calcaneal bursa and the gastrocnemius bursa. There is communication between the calcaneal bursa and the subcutaneous bursa in 37% of horses.

Fig. 79-1 Diagram of a sagittal section of the hock region showing the relative positions of the calcaneal and gastrocnemius bursae.

Injuries of the calcaneal bursa are not common and are usually the result of trauma. However, mild distention of the calcaneal bursa often is seen with gastrocnemius tendonitis (see page 803). Mild distention also may be seen unilaterally or bilaterally, as an incidental finding unassociated with lameness.⁵ Primary inflammation of the bursa results in acute-onset lameness associated with distention of the bursa. Hemorrhage into the bursa also may occur. Conservative management by rest, with or without injection of short-acting corticosteroids, usually results in resolution of lameness, although enlargement of the bursa may persist.

More commonly, infection of the bursa is caused by a penetrating injury or is secondary to infectious osteitis of the calcaneus^6,7 (see Chapter 44).

Stay updated, free articles. Join our Telegram channel

Join