A Case Report of Geyser Sign on Magnetic Resonance Imaging (MRI) in a 65-Year-Old Female Patient.

The geyser sign is the flow of arthrographic contrast or joint fluid from the glenohumeral joint across the acromioclavicular joint (AC) and occurs when fluid erupts from the superior aspect of the AC joint during arthrography. The cyst's pathogenesis is linked to a rotator cuff tear and an increase in the amount of fluid in the cyst. This fluid escapes through a one-way valve created by a defect in the AC joint capsule. The cysts, which are typically painless and rest over the AC joint, cause discomfort. We present a case of a 65-year-old female with a left shoulder mass. The patient presented to the outpatient department with a history of left shoulder mass for six months. She reported an increase in size with no constitutional symptoms. She was treated with surgical excision. Although rotator cuff tears and AC joint deterioration are rather common in medical practice, cystic swelling over the AC joint is a relatively uncommon symptom. Less than 50 cases have been reported to date. AC joint cyst is a mechanical consequence of a progressive and severe rotator cuff tear that can be misinterpreted as a tumor in older people. Imaging, particularly magnetic resonance imaging (MRI), should be used to rule out malignancy and make a precise diagnosis, including recognizing the "Geyser sign" if it is present.

Low-Cost Desktop-Based Three-Dimensional-Printed Patient-Specific Craniofacial Models in Surgical Counseling, Consent Taking, and Education of Parent of Craniosynostosis Patients: A Comparison With Conventional Visual Explanation Modalities.

BACKGROUND: Craniosynostosis is a complex craniofacial deformity. Surgical decision, if needed, is always hard on the parent and requires the use of multimodalities of explanation. To the authors' knowledge, there have been no studies tackling family counseling about the deformity and surgical decision-making process with the use of low-cost patient-specific three-dimensional (3D)-printed models. METHODS: A cross-sectional study investigating the utility of patient-specific 3D-printed models using a desktop-based 3D printer. Questionnaire was constructed and validated screening the demographics, knowledge, expectation, and surgical decision-making process supplied using Likert. Data were collected consecutively from each parent first after explanation with conventional 3D computed tomography (CT) images, and then repeated after the 3D-printed model has been presented. RESULTS: Fourteen parents were screened. Majority of parents considered the pathology to have a potential effect of child's functional and aesthetic outcomes. After using the 3D-printed models, the participants had a clear vision and needed not to read any more about the condition (P = 0.05, P = 0.019, respectively). Agreement for surgical management was in favor of the 3D-printed models compared with CT images (P = 0.028). Explanation with CT images yielded higher mean score in knowledge about potential complications compared with 3D models (P value = 0.007). For the 3D models, average printing time was 26 hours, and a mean cost of 5.2$. CONCLUSION: The utility of desktop 3D printing is an affordable modality to provide adequate information about craniosynostosis and can assist surgical decision-making. Knowledge and adaptation of such cheap technology represents a great skill aiding clinical practice.