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Die Akromioklavikulargelenkzyste

Eine Kasuistik und Zusammenfassung der Literatur

Acromioclavicular (AC) joint cyst

A case report and review of literature

  • Kasuistiken
  • Published:
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Zusammenfassung

Die Akromioklavikular- (AC-)Gelenkzyste gilt als seltene Folgeerkrankung nach kompletter Supraspinatussehnenruptur (SSR) und degenerativer Veränderung des AC-Gelenks. Sie fällt als erhabene Schwellung über dem AC-Gelenk auf und ist differentialdiagnostisch von Tumoren der Hals- und Schulterregion zu unterscheiden. Neben der klinischen Untersuchung trägt v. a. die Magnetresonanztomographie (MRT) zur Diagnosefindung bei. Die in der Literatur beschriebenen Behandlungsstrategien reichen von Beobachten, Punktion, Exzision der Zyste mit und ohne AC-Gelenkresektion bis hin zur Naht der darunter gelegenen Supraspinatussehne. Messen müssen sich die unterschiedlichen Therapieverfahren hinsichtlich der Komorbidität und der Rezidivhäufigkeit. Der kombinierten Zystenexzision mit gleichzeitiger operativer Naht der darunter liegenden Supraspinatussehne sowie der Resektion des AC-Gelenks werden die niedrigsten Rezidivraten zugesprochen. Wir berichten über einen 75-jährigen Patienten mit seit ca. 6 Monaten bestehender schmerzloser Schwellung über dem rechten AC-Gelenk nach einem 15 Jahre zurückliegenden Trauma.

Abstract

The acromioclavicular (AC) joint cyst is a rare sequela of complete supraspinatus tendon rupture and arthritis of the AC joint. It appears as a swelling on the AC joint and must be distinguished from tumours of the shoulder and neck region. Besides physical examination, magnetic resonance imaging is the most useful tool for correct diagnosis. As reported in the literature, therapeutic procedures include observation, aspiration, excision of the cyst with or without resection of the AC joint, and repair of the underlying supraspinatus tendon rupture. All procedures should be based on consideration of the comorbidity and recurrence of the cyst. Combinations of cyst excision and rotator cuff repair or AC resection seem to be the most promising therapeutic options. We report on a 75-year-old patient with a painless swelling over the AC joint who had suffered shoulder trauma 15 years previously.

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Authors and Affiliations

  1. Chirurgische Klinik und Poliklinik – Innenstadt, Klinikum der Universität München, Nussbaumstraße 20, 80336, München, Deutschland

    B. Ockert, W. Mutschler, P. Biberthaler & V. Braunstein

  2. AO Research Institute – AO Foundation, Davos, Schweiz

    B. Ockert

Authors
  1. B. Ockert
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  2. W. Mutschler
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  3. P. Biberthaler
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  4. V. Braunstein
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Correspondence to B. Ockert.

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Ockert, B., Mutschler, W., Biberthaler, P. et al. Die Akromioklavikulargelenkzyste. Orthopäde 38, 974–980 (2009). https://doi.org/10.1007/s00132-009-1468-9

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  • DOI: https://doi.org/10.1007/s00132-009-1468-9

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