Geyser sign (shoulder)

Dr Henry Knipe and Dr Matt A. Morgan et al.

The geyser sign may occur in some cases of long-standing rotator cuff tear and advanced degenerative change of the shoulder. 

It may present as a pseudotumour above the AC joint.

Chronic rotator cuff degenerative change and full-thickness tearing leads to instability of the humerus in the glenohumeral joint. Eventually, chronic impaction from the humeral head disrupts the inferior acromioclavicular (AC) joint capsule, and glenohumeral joint fluid "erupts" superiorly through the AC interval into the subdeltoid bursa.

Conventional arthrography
  • after injection of contrast dye into the joint space, leakage of the contrast into the subdeltoid bursa will be seen
  • background advanced degenerative changes in the shoulder with a full-thickness rotator cuff tear 
  • hypoechoic fluid collection above the AC joint
    • make sure that the collection is genuinely fluid and not an exuberant hypoechoic degenerative change of the AC joint
  • background advanced degenerative change in the shoulder with a full-thickness rotator cuff tear
  • T2: hyperintense fluid tracks from the glenohumeral joint space into the subdeltoid bursa​
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Article information

rID: 37617
Section: Signs
Synonyms or Alternate Spellings:
  • Geyser phenomenon
  • Acromioclavicular joint cyst
  • Geyser sign

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Cases and figures

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    Figure 1: a geyser in Yellowstone national park
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    Fluid collection ...
    Case 1: ultrasound
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    Case 2: ultrasound
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    Case 3: MRI
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    Case 4
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