Evaluation of Four Techniques for Injecting the Trochanteric Bursa of Horses

Objective: To describe the anatomic features of the equine trochanteric bursa and to evaluate 4 techniques for bursa centesis. Study Design: Prospective, randomized design. Animals: Equine cadavers (n=2) and 20 live horses. Methods: The trochanteric bursae of 2 equine cadavers were injected with latex to identify the boundaries of the bursae. Four techniques for centesis of the trochanteric bursa were evaluated by attempting to inject dye into both trochanteric bursae of 20 live horses. Techniques included injection of the bursa with the limb-bearing weight and injection with the limb nonweight bearing and supported on a block, with or without ultrasonographic guidance of the needle. Ultrasonographic guidance of the needle was performed with or without the use of a guide channel attached to the ultrasound probe. Each of the 4 techniques was used to inject 10 bursae. The region of the bursa was dissected after horses were euthanatized to determine the location of the dye. Results: The trochanteric bursa was most successfully injected with the limb positioned caudally with the foot on a block, even though topographic landmarks for centesis were more difficult to identify when the limb was in this position. The highest incidence of success was achieved when the needle was inserted using ultrasonographic guidance with the foot in a Hickman block. Conclusion: Positioning the limb caudally with the foot nonweight bearing and on a block facilitated centesis of the trochanteric bursa.