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Acromioclavicular joint cyst: nine cases of a pseudotumor of the shoulder

Tshering Vogel, Dechen ; Steinbach, Lynne ; Hertel, Ralph ; Bernhard, Juerg ; Stauffer, Edouard ; Anderson, Suzanne

In: Skeletal Radiology, 2005, vol. 34, no. 5, p. 260-265

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    Titre
    • Acromioclavicular joint cyst: nine cases of a pseudotumor of the shoulder
    Auteur
    • Tshering Vogel, Dechen. Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Bern, 3010, Bern, Switzerland
    • Steinbach, Lynne. Department of Radiology, University of California San Francisco, San Francisco, California, USA
    • Hertel, Ralph. Department of Orthopedics, Plastic and Hand Surgery, University Hospital of Bern, Bern, Switzerland
    • Bernhard, Juerg. Department of Rheumatology, Burgerspital, Solothurn, Switzerland
    • Stauffer, Edouard. Department of Pathology, University Hospital of Bern, Bern, Switzerland
    • Anderson, Suzanne. Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital of Bern, 3010, Bern, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:310993
    Summary
    Objective: (1) To analyse the imaging appearances of nine patients with acromioclavicular joint cysts presenting as shoulder masses for tumor staging with operative, histopathological and joint aspiration findings. Design and patients: Retrospective review of imaging and correlation with clinical, operative and surgical notes. Images were reviewed by two musculoskeletal radiologists by consensus. Nine patients who presented clinically with a shoulder mass were evaluated by radiographs (n=9), ultrasound (n=1), conventional arthrography (n=3), MRI (n=6; with direct MR arthrography n=2, indirect MR arthrography n=4). Results: All patients had a focal mass superior to the AC joint, with a size ranging from 1.5cm to 6cm and a mean of 3.27cm. Correlation was available with surgery (n=7), histopathology (n=2) and cyst aspiration (n=2). Two patients were managed conservatively. Geyser sign was positive in all three arthrograms. All MRIs revealed extensive rotator cuff tears with a column of fluid extending from the glenohumeral joint through the rotator cuff tear into the acromioclavicular joint and acromioclavicular cyst. Chondrocalcinosis was seen in the acromioclavicular joint cyst (n=2) and in the glenohumeral joint (n=1). Aspirate in two patients contained calcium pyrophosphate dihydrate crystals. Conclusion: Acromioclavicular joint cysts may present as a tumor mass. They are associated with extensive rotator cuff tears and there is usually communication of the cyst with the joint space. This feature excludes a diagnosis of tumor. AC joint cysts may be associated with calcium pyrophosphate dihydrate deposition disease