Geyser sign (shoulder)

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

Clinical presentation

~~A patient with degenerative change in the shoulder~~It may present ~~with~~as a pseudotumour above the AC joint.

Pathology

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.

Radiographic features

~~MRI~~

~~Background advanced degenerative change in the shoulder with full-thickness rotator cuff tear~~

~~T2:~~ ~~hyperintense fluid tracks from the glenohumeral joint space into the subdeltoid bursa~~

~~Ultrasound~~

~~Background advanced degenerative change in the shoulder with full-thickness rotator cuff tear~~

~~hypoechoic fluid collection above the AC joint~~
~~make sure that the collection is genuinely fluid and not exuberant hypoechoic degenerative change of the AC joint~~

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

-<p>The <strong>geyser sign</strong> may occur in some cases of long-standing rotator cuff tear and advanced degenerative change of the shoulder. </p><h4>Clinical presentation</h4><p>A patient with degenerative change in the shoulder may present with a pseudotumour above the AC joint.</p><h4>Pathology</h4><p>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.</p><h4>Radiographic features</h4><h5>MRI</h5><p>Background advanced degenerative change in the shoulder with full-thickness rotator cuff tear</p><ul><li>
-<strong>T2:</strong> hyperintense fluid tracks from the glenohumeral joint space into the subdeltoid bursa</li></ul><h5>Ultrasound</h5><p>Background advanced degenerative change in the shoulder with full-thickness rotator cuff tear </p><ul><li>hypoechoic fluid collection above the AC joint<ul><li>make sure that the collection is genuinely fluid and not exuberant hypoechoic degenerative change of the AC joint</li></ul>
~~-</li></ul><h5>Conventional arthrography</h5><ul><li>after injection of contrast dye into the joint space, leakage of the contrast into the subdeltoid bursa will be seen</li></ul>~~
+<p>The <strong>geyser sign</strong> may occur in some cases of long-standing rotator cuff tear and advanced degenerative change of the shoulder. </p><h4>Clinical presentation</h4><p>It may present as a pseudotumour above the <a title="AC joint" href="/articles/acromioclavicular-joint-1">AC joint</a>.</p><h4>Pathology</h4><p>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.</p><h4>Radiographic features</h4><h5>Conventional arthrography</h5><ul><li>after injection of contrast dye into the joint space, leakage of the contrast into the subdeltoid bursa will be seen</li></ul><h5>Ultrasound</h5><ul>
+<li>background advanced degenerative changes in the shoulder with a <a title="Rotator cuff tear" href="/articles/rotator-cuff-tear">full-thickness rotator cuff tear</a> </li>
+<li>hypoechoic fluid collection above the AC joint<ul><li>make sure that the collection is genuinely fluid and not an exuberant hypoechoic degenerative change of the AC joint</li></ul>
+</li>
+</ul><h5>MRI</h5><ul>
+<li>background advanced degenerative change in the shoulder with a full-thickness rotator cuff tear</li>
+<li>
+<strong>T2:</strong> hyperintense fluid tracks from the glenohumeral joint space into the subdeltoid bursa</li>
+</ul>

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