Presentation
Mass above left clavicle. Possible malignancy on recent gastroscopy.
Patient Data
Loculated cystic mass arising from the acromioclavicular joint, and extending medially into the subcutaneous tissues of the left supraclavicular fossa. The mass demonstrates no vascularity, and internally is principally hypoechoic, with small echogenic foci and echogenic layering.
Glenohumeral osteoarthritis characterized by joint space narrowing and marginal osteophytes. Superior subluxation of the humeral head in the glenoid with abutment and remodeling of the lateral acromial undersurface. Acromioclavicular joint widening.
Case Discussion
This patient had a history of chronic rotator cuff tear and rotator cuff tear arthropathy. This "mass" represents an acromioclavicular joint cyst, although ultimately from rotator cuff tear arthropathy damaging the inferior acromioclavicular joint capsule allowing ingress of glenohumeral synovial fluid into and then through the AC joint. This process is known as the "geyser sign".
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