Overview Biceps tenosynovitis occurs mainly due to degenerative changes of the intertrochanteric groove of the humerus tubercle and the tendon of the long head of the biceps brachii, the intertrochanteric groove is rough or narrowed, and the friction between the tendon and the tendon sheath is aggravated during shoulder abduction and external rotation activities, which results in the development of biceps tenosynovitis, causing pain in the anterior part of the shoulder and limitation of activities. Anatomy The long head of the biceps originates from the superior glenoid of the scapula, and the tendon passes through the shoulder joint in the fibrous canal formed by the shoulder groove of the humeral tubercle and the transverse ligament. During upper extremity activity, the long head of the biceps muscle moves in a transverse position of abduction and adduction, in addition to sliding up and down within the tendon sheath. However, because the tendon sheath is fixed in the groove of the humeral tuberosity, and there are bony protrusions of the humeral tuberosity on both sides to prevent it, so that the long head of the biceps muscle will not leave its original position, and it is often subjected to lateral stress and friction injuries. Clinical manifestations 1, anterior shoulder joint pain, can be radiated to the anterolateral upper arm, aggravated at night, aggravated by shoulder activities, and improved after rest. In the acute stage, the patient cannot take the affected side lying position, and it is difficult to put on or take off clothes. 2.Early shoulder activities are not yet obviously limited, but pain in abduction, extension and rotation. Gradually aggravated, shoulder joint activities are limited, and the affected hand cannot touch the opposite subscapularis angle. Pressure pain at the intertrochanteric sulcus of the humeral tuberosity was obvious. 4.Positive biceps resistance test: when resisting elbow flexion and forearm rotation, there is severe pain at the long head tendon of biceps. 5.Combined with frozen shoulder or other diseases, the pain range is wide, and shoulder joint stiffness and muscle atrophy can be seen. Diagnostic basis 1.Acute onset. Pain in front of shoulder joint, pain in shoulder lifting or extension, difficulty in dressing and undressing. 2, Shoulder abduction, posterior extension and rotation activities are limited and painful. 3.Painful pressure near the biceps interphalangeal groove and rostral eminence. Yergason’s sign is positive. 5.Often combined with frozen shoulder, with widespread pain, mild muscle atrophy, small shoulder joint mobility, or even loss of mobility, forming frozen shoulder. 6. Shoulder X-ray film: no osteoarticular changes. Therapeutic ideas and methods Non-surgical treatment is preferred for this disease. In the acute stage, suspension and fixation and pain point closure can be used; in the chronic stage, acupuncture and small-needle knife treatment are preferred. Surgery can be performed for chronic pain that is intolerable and recurrent. Suture hook needle treatment is recommended for the treatment of some stubborn and long-lasting biceps tenosynovitis, the pain point release, the direction of the needle parallel to the direction of the long head of the biceps muscle, first longitudinal peeling, and then transverse peeling. Then 3-4 ml of a mixture of 2% lidocaine 2 ml + tretinoin 40 mg + vitamin B12 500 mcg is injected at the point of release, and finally a band-aid is applied to the needle opening. All of them can be cured at once by following this method.