The Shoulder

Acute Bursitis with Calcium Deposits
Treatment

Local infiltration with Triamcinoloneacetonide.

Product

Because giving an infiltration into a severely inflamed bursa is extremely painful, a strong anaesthetic (Lidocaine 2%) is added to the fluid.
Both the superficial and deep parts must be infiltrated.
Therefore two syringes of 5 cc are used, each filled with 40 mg triamcinolone (use the 40mg/ml preparation) mixed with 3 to 4 cc Lidocaïne 2%(without adrenaline).
A needle of 5 cm long should be fitted tot both syringes.

Technique

Follow up and Results

Immediately after the infiltration the pain is relieved and thereafter the patient improves gradually with time. Most pain has gone after 24 hours.
Re-examination follows after 48 hours. If some pain still remains and palpation reveals some painful spot, a second infiltration ( 10 or 20 mg triamcinolone) is given here. If there is no pain on palpation, the infiltration is done under the acromion.
Full recovery is to be expected within days.
The tendency for recurrences is higher than in acute bursitis without calcium depositis. Should this be the case it is worth trying to dissolve the calcification with procaine infiltrations.