Abstract

BRAGA, Madalena; SOUSA, Joana P.  and  TORRES, João. “Pseudo-Geyser Sign” as the First Presentation of Septic Arthritis of the Shoulder. Gaz Med [online]. 2022, vol.9, n.3, pp.259-262.  Epub Sep 30, 2022. ISSN 2183-8135.  https://doi.org/10.29315/gm.v1i1.594.

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.

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