Traumatic Synovitis of the Glenohumeral Articulation

A patient with a shoulder injury, till he was cured at the orthopaedic department, 3 peritendinous steroid injections, each of them about 20 mg of Kenalog. Due to a restriction of motility and night pains the affection is closed as a frozen shoulder. Regarding to the fact that his state is not improving, he is finally marked as a not co-operative patient, and rehabilitation is done as insufficient at the rehabilitative department.

 

Ultrasound Finding

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picture and scheme of hydrops of the glenohumeral articulation in the axillary section, pathological distance is 8,2 mm of the articular capsule from the head of the humerus

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picture and scheme of tenovaginitis of the long head of the biceps, at traumatic synovitis and ruptures of labrum posterior

 

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picture and scheme of the effusion vs. ruptures of labrum posterior

 

videoclip of the effusion vs. ruptures of labrum posterior

MRI Picture

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MRI at a patient with ruptures of labrum glenoidale – in this picture there is seen a rupture of labrum glenoidale anterior – an arrow.

 

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MRI at a patient with ruptures of labrum glenoidale – in this picture there is seen tenovaginitis of the long head of the biceps – an arrow.

Commentary of Traumatic Synovitis and Ruptures of Labrum Glenoidale

A diagnosis of synovitis of the glenohumeral articulation and tenovaginitis of the long head of the biceps was clear, labrum posterior was normal during the ultrasound examination, but the diagnosis of a rupture is not possible to be determined. But MRI examination found, except diagnosis mentioned above, also a rupture of labrum anterior which cannot be found by the ultrasound examination. It shows that for the determining of the diagnosis, it is sometimes necessary to combine several methods. After an aspiration of a liquid from the glenohumeral articulation and from the sheath of the long head of biceps, where steroids were administered, the problems are quickly getting better.