Acromioclavicular joint cyst formation in a patient with rotator cuff-tear arthropathy: a rare cause of shoulder discomfort

Maziak, Nina; Plachel, Fabian; Scheibel, Markus; Moroder, Philipp

doi:10.1136/bcr-2018-226188

Cited by 7 publications

(12 citation statements)

References 17 publications

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“…In 1 case, there was a previous shoulder trauma on the affected side. [2][3][4][5][6][7]9,10,[12][13][14][16][17][18][19][20][21][22][23][24][25][27][28][29][30][31][32][33][34] Based on the patient's age, general condition, symptoms, and shoulder functionality, the treatment may be conservative or surgical. 21 In this review, 20 patients (35.1%) were treated conservatively with cyst aspiration, steroid injection, or no intervention at all, whereas 36 patients (63.2%) were surgically managed.…”

Section: Discussionmentioning

confidence: 99%

“…Failure of conservative methods (mainly cyst aspiration) to prevent continuous recurrences eventually led to surgical management of the cyst. 6,10,12,13,16,17,21,22,24,25,30,32,33 Surgical treatment for type I cysts may include CE, distal clavicle excision, and joint d ebridement. 13 As these cysts are isolated to the ACJ and do not communicate with the GHJ, shoulder reconstruction is not needed.…”

Section: Discussionmentioning

confidence: 99%

“…2,21 Although, there were 2 cases of type II cyst treated successfully only by aspiration and CE, respectively, we are hesitant about their long-term results because of the only 8month and 1-year follow-up. 17,31 If the rotator cuff can be repaired, it is the preferable method for better upper limb functionality, followed by cyst excision and acromioplasty. If the rotator cuff cannot be fixed, lateral clavicle excision and ACJ resection should be performed along with the cyst excision to eliminate the pinch valve effect, as in the case we present.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Gigantic acromioclavicular joint cyst: presentation and mini review

Christodoulou

Kakagia

Galanis³

et al. 2021

Journal of Shoulder and Elbow Surgery

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Acromioclavicular joint (ACJ) cyst is an uncommonly documented condition of the shoulder, first described by Craig. 5 According to Hiller's classification, 13 there are 2 types of cysts, based on the various etiologies that generate them. Type I cysts are caused by degenerative changes of the ACJ due to injury, metabolic/infectious disease, or excessive use and are therefore restricted to the joint, with an intact rotator cuff. Gradually, these changes can inflame the synovium, leading to the overproduction of fluid and cyst formation superficial to the ACJ. Type II cysts are associated with rotator cuff tears, partial or complete, and subsequent cuff tear arthropathy, including superior migration of the humeral head and irritation of the inferior ACJ capsule. Synovial fluid from the glenohumeral joint (GHJ) escapes through the subacromial/subdeltoid bursa (Geyser sign) into the ACJ, with the deteriorated capsule acting like a 1-way valve that prevents the fluid from returning, leading to the formation of a cyst. 6 We report a massive cyst over the right ACJ in an 80-yearold man, followed by a short literature review. PubMed database search was carried out using the terms acromioclavicular joint cyst, acromioclavicular joint ganglion cyst, ACJ cyst, and ACJ ganglion cyst. No date criteria were placed. All articles reporting the cyst's size and its underlying pathology, as well as the applied treatment methods and the recurrence rate, were included. The inclusion criteria were (1) full-text studies and (2) English language or official English translation provided. The initial research query provided 166 records. Eleven were excluded as duplicates, and 79 were irrelevant by reviewing the title. In addition, 2 cases describing a juxtaarticular myxoma and chondromyxoid fibroma, respectively, were excluded. From the remaining 76 reports, 10 were rejected by reviewing their abstracts, because of apparent irrelevancy. We tried to retrieve the full text of the remaining 66 articles. For 10 of them, the whole text could not be obtained; therefore, they were excluded. No official English translation was provided for 8 articles, which were also not included. A total number of 48 cases were thoroughly reviewed. Six were rejected because of irrelevant data and 6 because of a low level of evidence. A total of 34 studies finally entered the review, reporting 57 cases of ACJ cysts (Table I). A right-handed 80-year-old man was admitted to the hospital with a mass located above his right ACJ. His medical history was free, with the exception of pulmonary echinococcosis, diagnosed 40 years ago. The patient, a retired manual laborer, denied any previous shoulder trauma or any prior surgeries on the affected side, but complained of chronic right shoulder discomfort and mild pain during daily life activities, because of a gradually increasing shoulder lump. On physical examination, the mass measured 6.5 cm in diameter, 8 cm in length, 5 cm in Institutional review board approval was not required for this case report. This patient provid...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gigantic acromioclavicular joint cyst: presentation and mini review

Christodoulou

Kakagia

Galanis³

et al. 2021

Journal of Shoulder and Elbow Surgery

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“…However, some authors prefer to approach this pathology arthroscopically, performing a conservative subacromial decompression with preservation of the coracoacromial ligament and an accurate debridement of the cyst. Even in the cases treated arthroscopically, the authors performed AC joint resection [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Synovial cyst of the acromioclavicular joint with and without rotator cuff tear: A case series of two patients

Maio

Marcantonio

Luna

et al. 2020

International Journal of Surgery Case Reports

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Highlights The most common acromioclavicular joint cyst (AJC) is associated to a rotator cuff tear (type 2). MRI provides a correct diagnosis, even of the type of AJC. Type 1 AJC should be surgically treated by excision and resection of the lateral clavicle. Type 2 AJC could be surgically treated by reverse total shoulder replacement.

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“…If large enough, these masses may mimic a tumour on clinical assessment [ 87 ]. MRI can be an important diagnostic tool in these instances, and allow for concomitant evaluation of the AC joint, glenohumeral joint, and rotator cuff pathology [ 88 , 89 ].…”

Section: Acromioclavicular Jointmentioning

confidence: 99%

Magnetic resonance imaging of the shoulder

et al. 2020

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The aim of this article is to review the use of magnetic resonance imaging (MRI) for the evaluation of shoulder pain, which is a common clinical complaint of the musculoskeletal system. MRI is an essential auxiliary tool to evaluate these patients because of its high resolution and high sensitivity in depicting the soft tissues. This article will review the imaging technique, normal imaging anatomy, and most common imaging findings of disorders of tendons, labrum, and ligaments of the shoulder. It will also discuss common systemic diseases that manifest in the shoulder as well as disorders of the acromioclavicular joint and bursae. New advances and research in MRI have provided additional potential uses for evaluating shoulder derangements.

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Acromioclavicular joint cyst formation in a patient with rotator cuff-tear arthropathy: a rare cause of shoulder discomfort

Cited by 7 publications

References 17 publications

Gigantic acromioclavicular joint cyst: presentation and mini review

Gigantic acromioclavicular joint cyst: presentation and mini review

Synovial cyst of the acromioclavicular joint with and without rotator cuff tear: A case series of two patients

Magnetic resonance imaging of the shoulder

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