“Pseudo-Geyser Sign” as the First Presentation of Septic Arthritis of the Shoulder

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Madalena Peixoto de Sousa Braga - Corresponding Author

Madalena Peixoto de Sousa Braga [madalena.braga3@gmail.com]
Rua Prof. Fernando Magano, 140A, 4º esquerdo, 4250-541, Porto

Joana P. Sousa
João Torres

Abstract

Massive rotator cuff tears can lead to large cysts, extending from the subacromial space through the acromioclavicular joint into a subcutaneous cyst, with a typical “geyser sign” on magnetic resonance imaging (MRI). To our knowledge, no cases of transdeltoid pseudo-cyst as first manifestation of septic arthritis have ever been reported.
A 79-year-old female presented to the Emergency Department (ED) with a two-day evolution of a painful tumefaction over her right shoulder. She had been admitted to the ED 16 days before, after being bitten by a dog. Tumefaction drainage revealed a total cell count of 50320 cells/mL. MRI revealed glenohumeral joint cavity’s fluid “decompression” through the deltoid. Septic arthritis was presumed as the cause of the pseudo-cyst, configuring a “pseudo-geyser sign” on MRI.
Septic arthritis is an orthopedic emergency, whose early diagnosis, ED referral and treatment are crucial.

Keywords: Arthritis, Infectious; Rotator Cuff; Shoulder Joint

Article Details

1.
Braga M, Sousa JP, Torres J. “Pseudo-Geyser Sign” as the First Presentation of Septic Arthritis of the Shoulder. Gaz Med [Internet]. 2022 Sep. 1 [cited 2022 Nov. 30];9(3):259-62. Available from: https://gazetamedica.pt/index.php/gazeta/article/view/594
Section
CLINICAL CASE