RESUMO
Erosive bony lesions are a frequent manifestation of numerous etiologies, spanning from malignancy and metabolic disorders to chronic inflammatory conditions like sarcoidosis. However, arteriovenous malformations (AVM) are a less prevalent etiology for this condition. The presentation of erosive bony lesions is diverse, influenced by factors such as age, gender, size, and extent of the lesion. Multiple imaging modalities are employed to achieve a diagnosis, including plain radiograph, Doppler ultrasound, computed tomography, angiography, and magnetic resonance imaging.
RESUMO
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.
RESUMO
BACKGROUND: Distal humeral hemiarthroplasty has been performed for a variety of indications with the most common being management of distal humeral fractures. This systematic review evaluates the outcomes and complications of distal humeral hemiarthroplasty for this pathology. METHODS: We searched PubMed, EMBASE, and MEDLINE for studies reporting indications and outcomes of patients undergoing distal humeral hemiarthroplasty. Study screening, risk of bias assessment, and data extraction were performed. Summery statistics were provided. RESULTS: We included 11 studies (N = 163) in this review. In all studies, the indication for distal humeral hemiarthroplasty was the presence of an intraarticular, comminuted, unreconstructable fracture. The mean post-operative MEPS, FullDASH, and QuickDASH (SD) scores were 83.6 (6.1) points, 25.4 (10.3), and 15.7 (7.4) points, respectively. The mean post-operative range of motion (SD) was 106° (11°) in the flexion and extension arc and 153° (19°) in the protonation and supination arc. The overall rate of adverse events and complication was 63%. The rate for major complications was 11%. The mean total revision rate was 4% (0% to 15) and total re-operation rate was 29% (0% to 88%). CONCLUSION: Distal humeral hemiarthroplasty is a suitable option for unreconstructable distal humeral fractures and offers good functional outcomes with acceptable complication rates.
