Bicipital TENOSYNOVITIS Tenosynovitis

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BICIPITALBicipital TENOSYNOVITIS Tenosynovitis

WhatWhat is BICIPITAL is Bicipital TENOSYNOVITIS? Tenosynovitis? BicipitalBicipital tenosynovitis tenosynovitis is inflammation is inﬂ ammation of the of theorigin origin of the of bicepsthe biceps tendon tendon and its and its surroundingsurrounding tendon tendon sheath. sheath. The bicepsThe biceps tendon tendon originates originates from thefrom front the part front of part of the thescapula scapula (shoulder (shoulder blade). TheThe tendon tendon crosses crosses the the shoulder shoulder joint, joint, passes passes through the throughbicipital the groove bicipital of groove the humerus, of the humerus, and widens and intowidens the into biceps the muscle,biceps muscle, which attaches whichonto attaches the radius. onto Inﬂ the ammation radius. Inflammation of the biceps of tendonthe biceps can tendon result fromcan result chronic repetitive fromtrauma, chronic acute repetitive trauma, trauma, or other acute degenerative trauma, or other conditions degenerative of the shoulderconditions such as chronic of theosteochondritis shoulder such dissecans as chronic (OCD). osteochondritis An example dissecans of chronic (OCD). repetitive An example trauma of would be chronicexcessive repetitive jumping trauma activities. would be excessive jumping activities.

DiagnosisDiagnosis BicipitalBicipital tenosynovitis tenosynovitis usually usually occurs occurs in middle-aged in middle-aged to older, to older, medium medium to large to large breedbreed dogs. dogs. Dogs Dogs exhibit exhibit an intermittent an intermittent to constant to constant forelimb forelimb lameness lameness that is that is typicallytypically aggravated aggravated by exercise. by exercise. Pain Painis exhibited is exhibited on hyperflexion on hyperfl exion and and occasionally occasionallyhyperextension hyperextension of the affected of the affected shoulder. shoulder. Loss of forelimbLoss of forelimb muscle massmuscle is also a masscommon is also a fi commonnding. A presumptivefinding. A presumptive diagnosis ofdiagnosis bicipital of tenosynovitis bicipital is made by taking a tenosynovitisthorough history,is made performingby taking a thorougha comprehensive history, performing physical exam, a and by reviewing x-rays. comprehensiveX-rays may reveal physical mineralization exam, and by of reviewing the biceps x-rays. tendon, X-rays mineralization may reveal within the biceps mineralizationgroove, or sclerosis of the biceps (hardening tendon, of mineralization the bone, seen within as increased the biceps whiteness groove, or on x-rays) sclerosisbelow (hardening the biceps of groove. the bone, Ultrasound seen as increased may be used whiteness to look on for x-rays) structural below changes of the the biceps groove. Ultrasound may be used to look for structural changes of the biceps tendon or a joint fl uid sample may be obtained to help rule out infectious causes biceps tendon or a joint fluid sample may be obtained to help rule out of joint pain. A defi nitive diagnosis is made during arthroscopic shoulder exam. infectious causes of joint pain. A definitive diagnosis is made during arthroscopicTreatment shoulder exam. Medical management including controlled exercise, physical therapy, weight loss, Treatmentand anti-infl ammatory medications is the fi rst course of action. A steroid can also Medicalbe injected management into the including tendon sheath controlled to locally exercise, reduce physical infl ammation.therapy, weight The patient loss,must and beanti-inflammatory strictly rested (leash medications walks only) is the for first 4-6 course weeks of with action. no jumpingA steroid or rough can also be injected into the tendon sheath to locally reduce inflammation. The play allowed. If there is no improvement with medical management, then surgical patient must be strictly rested (leash walks only) for 4-6 weeks with no jumping management is considered. Surgery consists of completely cutting the biceps tendon or rough play allowed. If there is no improvement with medical management, after arthroscopic joint evaluation. After the tendon is cut and released out of the then surgical management is considered. Surgery consists of completely cutting degenerative biceps groove, it will adhere to the humerus over time affording normal the biceps tendon after arthroscopic joint evaluation. After the tendon is cut andbiceps released muscle out of function. the degenerative Non-steroidal biceps anti-infl groove, ammatory it will adhere medications to the can be used to humerusreduce over infl ammationtime affording and discomfortnormal biceps associated muscle function. with existing Non-steroidal shoulder arthritis. As anti-inflammatorywith most orthopedic medications conditions, can be weight used to management reduce inflammation is one of theand pillars to successful discomfortlong-term associated management. with existing shoulder arthritis. As with most orthopedic conditions, weight management is one of the pillars to successful long-term management.