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.