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

• Autor(es): Braga,Madalena ; Sousa,Joana P. ; Torres,João
• Data: 2022
• Origem: SciELO Portugal
• Assunto(s): Arthritis, Infectious; Rotator Cuff; Shoulder Joint
• Tipo de Documento: Relatório
• Idioma: Inglês

Descrição

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.