Sensitiveness of the Ultrasound Examination of Glenohumeral Hydrops

The ultrasound examination is sufficiently sensitive examination for a diagnosis of synovitis and hydrops of the glenohumeral articulation. Its sensitiveness is said to be the biggest one from all the examining methods. But ultrasound is only a part of the examination of a patient. Our work does not finish with the diagnosis of synovitis of the glenohumeral articulation. Based on my personal experience at the finding of synovitis we have to recommend again an aspiration of a synovial liquid from the articular cavity. There we would like to point out that the aspiration from the area of the glenohumeral articulation is not a simple matter. At the clear ultrasound finding of synovitis we repeatedly tried to aspirate from the articular cavity (dorsal approach), and we were always surprised that we had to use a pink needle, and incite a negative pressure of a 20 ml syringe to gain this exudate. If we had not the ultrasound finding , we would not behave to this joint so “roughly”.  It is necessary to keep in mind that the synovial liquid does not have to be only inflammatory etiology, and that inflammatory synovitis also has a possibility of various etiology. Therefore it is necessary to do a basic biochemical, cultural, cytological and microscopic examination for a finishing of the differential diagnostics of basic pathological states – an infection, crystals, an inflammation etc. (see examination of a synovial liquid). In our opinion, the finding of isolated articular hydrops, in the case of a trauma in the anamnesis, should be an indication for a performance of arthroscopy of the glenohumeral articulation when patient’s problems continue.