Traumatic Tenovaginitis

Traumas of a tendon of the long head of the biceps are followed by an inflammation of the tendon, and they can be grateful due to steroid peritendinous injections in later stages into tendinous sheath. Commonly traumatic tenosynovitides can be said to be more grateful after therapy than tenosynovitides at rheumatoid affections. Therefore it is necessary to emphasize once again the meaning of the local application of steroids because in each case the application of steroids is connected with a big relief and a complete remission of the state.

We regularly met a finding of a liquid along the long head of the biceps at:

luxation of the glenohumeral articulation (tenovaginitis belongs to the most frequent cause of problems outlasting after surgical reattachment of the luxated humerus head

repeatedly !!! at the fracture of surgical cervix of the humerus

contusion of the shoulder

In all these cases we have met with problems (in our opinion) which are typical for the affection of the tendon of the long head of the biceps (see clinical picture of bicipital tendinitis) and which were rather given in the  connection to a primary affection. A sanguinolent exudate was always aspirated without any presence of cells. We made a peritendinous injection with steroids 12 mg Depomedrol which improved these problems by 50%. Patients were satisfied with this result even if we were never able to eliminate them completely. We do not know if the improvement was the result of the extraction of the exudate, or rather the effect of steroids, or the combination of both these mechanisms. We do not also know if the localization of the liquid in the tendinous sheath corresponds to the affection of the tendon, or if it is the result of anatomic rates which lead to concentration of the liquid in the sheath of the long head of the biceps after injuries (from the articular cavity?).

 

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picture and scheme of traumatic tenosynovitis in the transversal section

videoclip of traumatic tenosynovitis in the transversal section

 

 

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picture and scheme of traumatic tenosynovitis in the longitudinal section

 

videoclip of traumatic tenosynovitis in the longitudinal section