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A chronic degenerative 'bursitis' is quite common in elderly patients. It usually originates in combination with a chronic and progressive rotator cuff failure. Degeneration and ruptures in the supra- and infraspinatus will then occur in combination with an extensive subacromial bursitis .

1. There is no improvement with the ongoing treatment

  1. Are you sure about the diagnosis?
  2. Are you sure of the localisation?
  3. Treat with corticosteroids?
    Infiltrate the same location with a mixture of local anaesthetic and triamcinolone (depending on the extension of the lesion with 10 to 40 mg).

2.There is a recurrence after initial improvement

  1. Infiltrate with increasing intervals

  2. Or repeat the injection every two weeks until the complaints have completely disappeared.(normally after two to three injections).
  3. Treat the underlying cause