The Shoulder

CHRONIC SUBDELTOID BURSITIS

There is no improvement with the ongoing treatment

Are you sure of your diagnosis?

Diagnosing a chronic subdeltoid bursitis is not always easy.
- Classically, there is no pain with resisted movements.(Pattern).
- Nevertheless, sometimes resisted movements can all or partially be painful as a result of transmitted stress.
- Sometimes, a chronic subacromial bursitis may be characterized by a minor limitation of movement in accordance with a non capsular pattern
Are you sure of the location?

The acromio-deltoid bursa is rather extensive. A local infiltration can only show a result if the exact location is being found. Therefore, the following tips may be of interest:
- first, palpitate the subdeltoid regio thoroughly, and compare the tenderness with the other side.
- then, infiltrate with a weak solution of local anaesthetics (technique) .
- repeat the functionial examination. If the signs have not disappeared, concentrate on the deep, subacromial part
- infiltrate the subacromial regio in a systematic way with a weak solution of local anaesthetic ( technique)
The local anaesthetic results in improvement for only a couple of hours
- Infiltrate the same location with a mixture of local anaesthetic and triamcinolone (depending on the extension of the lesion with 10 to 40 mg).
- Repeat the injection every two weeks until the complaints have completely disappeared.(normally after two to three injections)