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 pseudotumor 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.
- 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
- 1. Craig EV. The geyser sign and torn rotator cuff: clinical significance and pathomechanics. Clin. Orthop. Relat. Res. 1985; (191): 213-5. Pubmed citation
- 2. Hiller AD, Miller JD, Zeller JL. Acromioclavicular joint cyst formation. Clin Anat. 2010;23 (2): 145-52. doi:10.1002/ca.20918 - Pubmed citation
- 3. Cooper HJ, Milillo R, Klein DA et-al. The MRI geyser sign: acromioclavicular joint cysts in the setting of a chronic rotator cuff tear. Am J. Orthop. 2011;40 (6): E118-21. Pubmed citation