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.