In the vast majority of cases, supracarpal bursitis occurs as a result of external trauma (such as hitting the front of the carpus against the stall door or gate) rather than internal injury. The swelling is a result of extra synovial fluid within the "bursa" that lubricates the common digital extensor (CDE) tendon as it courses over the front of the carpal (knee) joint(s).
You may notice that the swelling appears to be most evident just above and just below the carpus. This is due to the presence of a fibrous retinaculum that courses tranversely around the carpus and "pushes" the fluid above and below its margins.
CDE tenosynovitis/ supracarpal bursitis does not usually cause lameness and is typically considered to be a cosmetic issue. In severe cases, however, excessive distention of the bursa may prevent the carpus from flexing completely (due to increased internal pressure) and result in mild to moderate nonweightbearing thoracic limb lameness.
As you may know, bursas are designed to provide an environment in which tendons may easily slide over or under flexor surfaces (i.e. joints). Bursas contain synovial fluid very similar to that found in joints. The fluid lubricates the tendon as it slides overtop or underneath. Extra fluid within the bursa develops as a result of compromise/ inflammation associated with the tendon residing within it. This abnormality is referred to as "bursitis" and simply means that there is inflammation within the bursa.
Inflammation present within the supracarpal bursa tends to "linger" once it develops. In some cases the swelling resolves spontaneously; in the majority of cases, however, some degree of swelling persists until it is treated.
Treatment usually involves drainage of the fluid via needle aspiration and subsequent injection with a combination of synthetic hyaluronan and corticosteroid (and sometimes atropine). The cost to perform this procedure (including medications and sedation) is approximately $250. More conservative treatment in the form of topical Dexamethasone Sweat Spray (applied once daily for about 10 days) has also successfully resolved many (less severe) cases in our hands. This product can be ordered through our PHARMACY.
Recurrence rate following treatment is approximately 15-20%.