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HELP : TREATMENT
CHRONIC SUBDELTOID BURSITIS
1. There is no improvement with the ongoing treatment
1.Are you sure of your diagnosis?
Diagnosing a chronic subdeltoid bursitis is not always easy.
2 .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:
3.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).
2. The complaints recur after an initial improvement
1. Sporadic relapses after complete recovery
With a relapse after an initially successful treatment, the treatment can be repetead. However, in this case it is important to provide a thorough follow up: the treatment is continued until the clinical examination is completely negative. A treatment can again be set up if there are not too many relapses (not more than two to three relapses)
2. Repeated relapses
With repeated or rapidly successive relapses one should bear in mind an underlying cause:
If an anatomical deviation causes the relapse of the bursitis, then, a surgical decompression with removal of the front and lower part of the acromion and of the coraco-acromial ligament can offer a definite solution.