Result of the Untargetable Therapy with Steroids

We repeatedly meet a finding of a highly viscid artrocentesis from the tendinous sheath of the long head of the biceps. Their presence is connected with an anamnesis of long lasting problems mostly for several months or years. This finding is mostly thought to be a result  of exudative tenosynovitis which finishes with a change of a character of the liquid which was originally inflammatory and changed into uninflammatory one. An untargetable steroid injections, which have a buffer effect on the inflammatory reaction and exudation, but they are not able to remove the liquid from the sheath of the tendon of the long head of the biceps,  often precede this state. The therapy of these states is quite difficult. The aspiration of the dense exudate by a needle under the ultrasound is seldom able to remove all the content, and also in the case of aspiration of all the content the recidivities can occur. Sometimes the content along the tendon is so dense that we are able to aspirate only a few drops. In our opinion, at this type of tenosynovitis an operation is necessary. A surprising fact is that also a very small amount of the liquid in the sheath can call up so big clinic problems.