Presentation
Shoulder pain and swelling above the right acromion-clavicular joint in a spinner working in a spinning mill using her arm very frequently experiencing repetitive microtrauma. Range of motion normal.
Patient Data
MRI imaging showed a 4 × 2 × 3.5 cm mass related to the right AC joint, with little full-thickness rupture of the supraspinatus muscle, anteriorly. There’s also AC degeneration with bone marrow oedema of the distal head of the clavicle. Normal the glenoid labrum.
Performed aspiration of the cyst but the cyst again recurred.
Surgery report
Lateral end clavicle and degenerated joint meniscus resection associated at double breasting of the AC joint capsule defect with subacromial bursectomy.
Case Discussion
Cysts of the acromioclavicular joint are of two types (Hiller et al.):
type 1: secondary to advanced osteoarthritis of the acromioclavicular (AC) joint
type 2: secondary to chronic rotator cuff injury
In this case (cyst type 1) there is advanced AC joint arthritis with synovial inflammation and the cysts are limited to the joint and are not associated with a massive rotator cuff tear. Ganglion cysts differ from synovial cysts in the lack of a synovial lining. Nonsurgical treatments such as aspiration are typically associated with a high recurrence rate.
Radiographer: TSRM Fabio Imola
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