Progressive Prominent Swelling Over the Acromioclavicular Joint
An 81-year-old man (no relevant medical history, no medications) reported a progressive, mobile swelling over the acromioclavicular (AC) joint, present for several months. Sonographic examination confirmed the liquid nature of the mass. Three aspirations of the content by the patient’s family physician before eventual referral to the hospital were successful only in the very short term: just a few hours later, the swelling was as large as before. The patient suffered no pain during normal daily activity, but was bothered by the appearance of the lesion and above all by the difficulty he experienced in getting dressed and in wearing his rucksack. Magnetic resonance imaging showed advanced osteoarthritis of the AC joint with a prominent AC joint cyst and the characteristic geyser sign. Because of the clinical symptoms the patient was treated with arthroscopic resection of the AC joint and open resection of the AC joint cyst. Six months later the skin and operation scar showed no signs of inflammation. No recurrence was reported.
Dr. med. Kristian Nikolaus Schneider, Prof. Dr. med. Georg Gosheger, Prof. Dr. med. Dennis Liem,
Universitätsklinikum Münster, Klinik für Allgemeine Orthopädie und Tumororthopädie, firstname.lastname@example.org
Conflict of interest statement: The authors declare that no conflict of interest exists.
Translated from the original German by David Roseveare
Cite this as: Schneider KN, Gosheger G, Liem D: Progressive prominent swelling over the acromioclavicular joint. Dtsch Arztebl Int 2019; 116: 38. DOI: 10.3238/arztebl.2019.0038