## Overview Bicipital bursitis is inflammation of the bursa that lies between the biceps brachii tendon and the humerus at the point of the shoulder. The bursa allows the tendon to glide smoothly. Inflammation may be aseptic (from trauma or overuse) or septic (from penetrating wounds or, rarely, blood-borne infection). Because little soft tissue covers the area, the bursa is vulnerable to external trauma. ## Causes Direct trauma, kicks, or falls are the most common triggers. Penetrating wounds introduce bacteria and produce septic bursitis. Overuse and concurrent biceps tendon injury can cause aseptic inflammation. Brucella species have historically been implicated in some cases. ## Diagnosis Forelimb lameness with a shortened cranial stride, heat, swelling, and pain at the point of the shoulder are typical. Ultrasound-guided synoviocentesis confirms sepsis when present. Radiographs and ultrasound evaluate concurrent bone or tendon damage. ## Treatment Aseptic cases are managed with rest, anti-inflammatories, and sometimes intrabursal medication. Septic bursitis requires aggressive lavage (bursoscopy or through-and-through needle lavage) plus systemic antibiotics. Prognosis is fair with prompt treatment. ## Recovery and Prognosis Many horses become serviceably sound. Return to high-level athletics is less certain, especially after septic disease or significant tendon involvement. Chronic cases may leave residual mechanical limitation. ## Prevention Prompt wound care after shoulder trauma and avoidance of repeated contusion reduce risk.
forelimb lameness; swelling and heat at the point of the shoulder; pain on palpation; shortened cranial phase of the stride
## Overview Bicipital bursitis is inflammation of the bursa that lies between the biceps brachii tendon and the humerus at the point of the shoulder. The bursa allows the tendon to glide smoothly. Inflammation may be aseptic (from trauma or overuse) or septic (from penetrating wounds or, rarely, blood-borne infection). Because little soft tissue covers the area, the bursa is vulnerable to external trauma. ## Causes Direct trauma, kicks, or falls are the most common triggers. Penetrating wounds introduce bacteria and produce septic bursitis. Overuse and concurrent biceps tendon injury can cause aseptic inflammation. Brucella species have historically been implicated in some cases. ## Diagnosis Forelimb lameness with a shortened cranial stride, heat, swelling, and pain at the point of the shoulder are typical. Ultrasound-guided synoviocentesis confirms sepsis when present. Radiographs and ultrasound evaluate concurrent bone or tendon damage. ## Treatment Aseptic cases are managed with rest, anti-inflammatories, and sometimes intrabursal medication. Septic bursitis requires aggressive lavage (bursoscopy or through-and-through needle lavage) plus systemic antibiotics. Prognosis is fair with prompt treatment. ## Recovery and Prognosis Many horses become serviceably sound. Return to high-level athletics is less certain, especially after septic disease or significant tendon involvement. Chronic cases may leave residual mechanical limitation. ## Prevention Prompt wound care after shoulder trauma and avoidance of repeated contusion reduce risk.
forelimb lameness; swelling and heat at the point of the shoulder; pain on palpation; shortened cranial phase of the stride