Development of a Novel Medial Synoviocentesis Approach to the Bicipital Bursa in an Equine Cadaver Model.
Authors: Grabski Milosz, McNamara Jennifer, Roper Darren, Warren-Smith Chris, Busschers Evita
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Medial Approach to Bicipital Bursa Synoviocentesis The bicipital bursa—a fluid-filled sac that cushions the biceps tendon at the shoulder—can develop clinically significant pathology, yet accessing it has traditionally relied on lateral needle approaches that may be anatomically challenging. Grabski and colleagues used computed tomography imaging of seven distended cadaveric bursa specimens to establish precise anatomical dimensions (median volume 51 mL, length 9.02 cm, width 7.06 cm), then performed detailed dissection and polyurethane casting to map the bursa's relationship to surrounding musculature, identifying the medial aspect at the junction of the subclavius and biceps muscles. On eight intact cadavers, they validated a novel medial synoviocentesis technique using the lateral pectoral sulcus as an external landmark, achieving successful bursal access in all specimens with needle insertion 5–10 mm craniolateral to the sulcus centre, positioned midway between the palpable distal deltoid tuberosity and cranial greater tubercle. For practitioners managing bicipital bursitis or requiring bursal sampling, this medial approach offers a potentially more reliable alternative to lateral techniques, though clinical validation in living horses is still required to confirm its safety profile and diagnostic utility before widespread adoption.
Read the full abstract on PubMed
Practical Takeaways
- •A new medial approach to the bicipital bursa is now available as an alternative to lateral techniques, using the lateral pectoral sulcus as an external palpable landmark
- •The technique has been validated in cadavers with consistent anatomical landmarks, but clinical use in live horses requires further safety and efficacy testing
- •Practitioners should await peer-reviewed validation in live horses before adopting this approach clinically
Key Findings
- •Bicipital bursa median dimensions: 9.02 cm length, 7.06 cm width, 51 mL volume
- •Medial bursa wall located at junction of subclavius and biceps muscles, corresponding to lateral pectoral sulcus
- •Novel medial synoviocentesis approach using landmark 5-10 mm craniolateral to center of lateral pectoral sulcus was 100% successful in cadaveric models (8/8)
- •Medial approach provides alternative access to bicipital bursa versus existing lateral approaches