Geyser sign (shoulder)

Case contributed by Maulik S Patel
Diagnosis almost certain


Complaining of swelling abutting left shoulder for last few months. It is associated with restricted of shoulder movements and shoulder pain. There was no trauma.

Patient Data

Age: 85 years
Gender: Female

There is a proximal migration of humeral head with a reduction in acromion-humeral distance. There is subchondral sclerosis involving adjacent surfaces of humeral head and acromian process of the scapula. The glenohumeral joint shows joint space reduction, subchondral sclerosis, marginal osteophyte. There is a soft tissue swelling abutting cranial aspect of the left acromioclavicular joint. There is no fracture /dislocation / bony lesion.


There is an encapsulated fluid abutting cranial aspect of the acromioclavicular joint. It is not compressible. There are tiny echoes within. It measures about 40 x 31 x 20 mm.  There is non-visualization of supraspinatus, infraspinatus, biceps long head and subscapularis tendons. However, teres minor tendon is intact. There are gross atrophy and fatty infiltration of supraspinatus and infraspinatus tendons. There is the presence of the bursal effusion.

Case Discussion

Case shows classical findings of geyser sign of shoulder. There is chronic cuff tear, degenerative disease of the glenohumeral joint and encysted fluid abutting acromioclavicular joint.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

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

 Thank you for updating your details.