Podotrochlear bursa endoscopy in the horse: a cadaver study.
Authors: Cruz A M, Pharr J W, Bailey J V, Barber S M, Fretz P B
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Podotrochlear Bursa Endoscopy in the Horse Understanding the internal pathology of navicular disease requires reliable diagnostic techniques beyond radiography alone. Cruz and colleagues examined podotrochlear bursa endoscopy as a diagnostic tool by performing endoscopic examinations on 17 cadaver forelimbs using a 4-mm arthroscope, correlating findings with standard radiographs, bursograms, and subsequent dissection and gross pathology. Abnormal endoscopic findings—including deep digital flexor tendon fibrillation, navicular bone fibrocartilage defects, and synovial hyperplasia—were identified in only 3 limbs, though notably two of these observations could not be confirmed on gross examination, raising questions about false-positive findings and interpretative reliability. The technique proved technically challenging, with difficulties visualising the bursa ipsilateral to the arthroscope portal and reported complications including inadvertent penetration of adjacent structures and iatrogenic damage to the navicular fibrocartilage during the procedure itself. For practitioners considering endoscopy in cases of suspected podotrochleosis, this work suggests potential diagnostic value—particularly in identifying early synovial and soft tissue changes—yet the false-positive rate and technical demanding nature warrant careful case selection and operator experience to minimise morbidity and maximise diagnostic yield.
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Practical Takeaways
- •Podotrochlear bursa endoscopy shows promise for detecting early pathologic changes in navicular disease, but cadaver validation suggests it may have limitations in mild cases
- •If using this technique clinically, be aware of anatomical risks including inadvertent penetration of the distal interphalangeal joint and digital sheath, and potential for iatrogenic fibrocartilage damage
- •Endoscopic findings should be interpreted cautiously in mild radiographic disease and correlated with other diagnostic imaging
Key Findings
- •Podotrochlear bursa endoscopy identified abnormal findings (fibrillation, fibrocartilage defects, synovial hyperplasia) in 3 of 17 cadaver limbs (18%)
- •Endoscopic observations in mild radiographic disease (score 1) were not confirmed on gross dissection, but were confirmed in severe disease (score 3)
- •Only 1 specimen showed abnormal bursography findings, correlating with confirmed endoscopic pathology
- •Technical challenges included difficult visualization of ipsilateral bursal wall and risk of iatrogenic damage to adjacent structures