Ultrasonography Leads to Accurate Diagnosis and Management of Painful Acromioclavicular Joint Cyst

George C Chang Chien, Craig S Best, Brian S Clay, Kenneth D Candido
Pain Practice: the Official Journal of World Institute of Pain 2015, 15 (7): E72-5

BACKGROUND: Acromioclavicular joint (ACJ) cysts are uncommon causes of shoulder pain. Type 1 ACJ cysts are limited to the ACJ and form in the presence of intact rotator cuff musculature, while type 2 cysts form secondary to biomechanical instability following rotator cuff tear or rupture.

CASE PRESENTATION: A 36-year-old overweight male with history of chronic left grade 2 (Rockwood classification) ACJ separation presented with intermittent pain at the distal superoanterior left clavicle. Physical examination revealed small step off at the ACJ and multiple subcutaneous cysts surrounding the ACJ. Ultrasound examination revealed a mild separation of the left ACJ, mild distension of the joint capsule, and a small, well-circumscribed, compressible hypo-echoic cyst overlying the clavicle. Palpation of the cyst against the clavicle reproduced the patient's symptoms of intermittent pain. He opted for ultrasound-guided aspiration and subsequently had full resolution of his symptoms.

DISCUSSION: Musculoskeletal ultrasound is useful for diagnosis and management of refractory musculoskeletal conditions that are commonly misdiagnosed on physical examination and translucent to radiographic imaging. Musculoskeletal ultrasound allowed us to exclude rotator cuff pathology, identify ACJ cyst as the pain generator, classify it as a type 1 ACJ cyst, and aid in needle guidance for successful aspiration leading to full resolution of our patient's pain.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"