title: The cranial nuchal bursa: anatomy, ultrasonography, magnetic resonance imaging and endoscopic approach.
abstract: BACKGROUND
  Although an uncommon condition, cranial nuchal bursitis can affect the performance of the equine athlete. The anatomy is not well described and there are no reports of diagnostic imaging for endoscopic approaches.
  
  
  OBJECTIVE
  To describe the anatomy, ultrasonographic and magnetic resonance features of and endoscopic approach to the cranial nuchal bursa in horses.
  
  
  METHODS
  Experimental cadaver study.
  
  
  METHODS
  Four cranial nuchal bursae were dissected, 4 specimens were frozen to prepare anatomical sections and 2 were injected with latex to document surface landmarks and topographical anatomy and to identify the possible sites for endoscopic access. Six cadaveric specimens were used to describe the ultrasonographic and magnetic resonance features of the cranial nuchal bursa before and after intrabursal injection. Sixteen cadaver specimens were evaluated with a rigid arthroscope and gross dissection to determine the endoscopic appearance of the bursa.
  
  
  RESULTS
  The cranial nuchal bursa could be identified consistently in all cadavers, using ultrasonographic and magnetic resonance on both pre- and post injection specimens. Cranial and caudal endoscopic approaches and instrument portals were developed for the cranial nuchal bursa. Using either approach, the entire extent of the bursa could be evaluated, but separate approaches for left and right compartments of the bursa were needed owing to the lack of manoeuvrability when examining the contralateral compartment.
  
  
  CONCLUSIONS
  The cranial nuchal bursa can be identified on ultrasonographic and magnetic resonance images. An endoscopic approach to the cranial nuchal bursa is clinically feasible and offered an easy, repeatable entry into the cranial nuchal bursa, which allowed adequate observation of the structures within the bursa. This may be of help for diagnosis and treatment of conditions affecting the cranial nuchal bursa in horses.
authors.affiliation: Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Abuja
authors.forename: J M
authors.initials: JM
authors.lastname: García-López
authors.forename: G
authors.initials: G
authors.lastname: Manso-Díaz
authors.forename: T J P
authors.initials: TJ
authors.lastname: Spoormakers
authors.forename: O
authors.initials: O
authors.lastname: Taeymans
mesh_terms: D000818:Animals; D006736:Horses / Q000033:anatomy & histology*; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000662:veterinary*; D009333:Neck / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D011859:Radiography; D014463:Ultrasonography / Q000379:methods / Q000662:veterinary*
keywords: anatomy; bursoscopy; cranial nuchal bursa; horse; magnetic resonance; ultrasound