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
Ultrasound
  • 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
MRI
  • 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​
Share article

Article information

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

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Figure 1: a geyser in Yellowstone national park
    Drag here to reorder.
  • Drag
    Fluid collection ...
    Case 1: ultrasound
    Drag here to reorder.
  • Drag
    Case 2: ultrasound
    Drag here to reorder.
  • Drag
    Case 3: MRI
    Drag here to reorder.
  • Drag
    Case 4
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.