Idiopathic Tenosynovitis and Tendinitis of the Long Head of the Biceps

According to some authors tenditinis and tenovaginitis of a long head of the biceps are rare, this claim cannot be accepted.

      If we judge a frequency of inflammatory changes in the structures of the shoulder joint, tendinitis and tenovaginitis of the tendon of the long head of the biceps are the most frequent inflammatory affection of the shoulder girdle.


Tenovaginitis of the long head of the biceps can occur simultaneously with synovitis of the glenohumeral joint, but most frequently it occurs lonely. Tenovaginitis of the long head of the biceps seems to be felt worse than synovitis of the shoulder joint itself, and affected patients see a doctor immediately. Chronic synovitis of the shoulder joint at rheumatoid arthritis can be felt as a not so much annoying pain inside the shoulder joint rather with a big restriction of motility. At tenovaginitis of the long head of the biceps the patients are not satisfied with their state, and immediately after their coming to the surgery, they speak about terrible pains and a big restriction of motility of the shoulder. Also minimal tenosynovitis of the sheath influences movements of the glenohumeral articulation. ”A classical” rheumatoid affection, at which the bicipital tenovaginitis occurs, is rheumatoid arthritis or psoriatic arthropathy. Most frequently we meet patients by whom the determination of diagnosis is more difficult because of long time delays between attacks of the primary affection. So we meet patients with alternate  or reversible tenovaginitides  of the long head of the biceps, at which isolated synovitis of a knee or an astragalus during several years, swellings of a tarsus, pains of elbows or heels. Most of these patients have attacks of several months lasting pains not only in the lumbar spine but also in the cervical spine, and this fact brings the diagnosis of vertebrogenic problems. By all these patients we intently  took the picture of SI articulation, a finding was normal, and most patients were HLA B27 negative. Even so we think that it deals with a form of undifferentiated seronegative sponarthritides of  matutinal type. But in our opinion, present diagnostic criteria are not able to interpret simply the active affection.