Progressive Prominent Swelling Over the Acromioclavicular Joint

An 81-year-old man (no relevant medical history, no medications) reported a progressive, mobile swelling

over the acromioclavicular (AC) joint, present for several months. Sonographic examination confirmed the liquid nature of the mass. Three aspirations of the content by the patient’s family physician before eventual referral to the hospital were successful only in the very short term: just a few hours later, the swelling was as large as before. The patient suffered no pain during normal daily activity, but was bothered by the appearance of the lesion and above all by the difficulty he experienced in getting dressed and in wearing his rucksack. Magnetic resonance imaging showed advanced osteoarthritis of the AC joint with a prominent AC joint cyst and the characteristic geyser sign. Because of the clinical symptoms the patient was treated with arthroscopic resection of the AC joint and open resection of the AC joint cyst. Six months later the skin and operation scar showed no signs of inflammation. No recurrence was reported.

Translated from the original German by David Roseveare

Cite this as: Schneider KN, Gosheger G, Liem D: Progressive prominent swelling over the acromioclavicular joint.

Figure 1.