Department of Orthopedic Surgery, National Defense Medical Center,Tri-Service General Hospital, Neihu 114,Taipei,TaiwanTaiwan
Department of Orthopedic Surgery, National Defense Medical Center,Tri-Service General Hospital, Neihu 114,Taipei,Taiwan; Department of Orthopedic Surgery, Hualien Armed Forces General Hospital,Taiwan, Republic of ChinaChina
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We are very interested in the article by Sarman et al.1 A rare cause of shoulder pain: Ganglion cyst of the acromioclavicular joint.1 Ganglion cyst often induces severe pain and impairs quality of life, even with multi-modal therapies. The ganglion cyst commonly develops along the tendons or joints. Ganglion cysts are typically round or oval shape and filled with a jellylike fluid. We appreciated the rare case report by Sarman et al.1 Sarman et al1 performed an image investigation to clarify the tissue content by an Xray and an magnetic resonance imaging (MRI) examination. They found a 10×8×5 cm mass which was homogenous fluid contained with a septum. And the lesion had several cysts in the T2 image. Although, it looked like a benign lesion as the author described, a painful mass raised the alarm. The possibility of malignant change is because of the lesion size which is bigger than 5 cm as well as a deep mass or one adhering to the fascia.2 Conversely, a mass that moves with the muscle tissues is probably superficial and less likely to be malignant.
Keywords: X-ray, T2 image, i (MRI), surgery
Open Journal PUBLISHERS Letter to the Editor A Few Considerations on “A Rare Cause of Shoulder Pain Ganglion Cyst of the Acromioclavicular Joint”: A Letter to the Editor 1 1,2* Lee C.Tse, MD ; Zhi-Hong Zheng, MD 1Department of Orthopedic Surgery, National Defense Medical Center,Tri-Service General Hospital, Neihu 114,Taipei,Taiwan 2Department of Orthopedic Surgery, Hualien Armed Forces General Hospital,Taiwan, Republic of China * *Corresponding author Zhi-Hong Zheng, MD Department of Orthopedic Surgery, National Defense Medical Center,Tri-Service General Hospital, Neihu 114,Taipei,Taiwan; Department of Orthopedic Surgery, Hualien Armed Forces General Hospital,Taiwan, Republic of China; E-mail: rara540@gmail.com Article information th th st Received: September 6 , 2022; Accepted: September 15 , 2022; Published: September 21 , 2022 Cite this article Tse LC, Zheng Z-H. A few considerations on “a rare cause of shoulder pain ganglion cyst of the acromioclavicular joint”:A letter to the editor. Osteol Rheumatol Open J. 2022; 4(1): 1-2. doi: 10.17140/ORHOJ-4-116 TO THE EDITOR tear untreated may not be sufficient for shoulder pain. Surgeons often use 50% of footprint tears as an indication for surgery for e are very interested in the article by Sarman et al.1 A rare PTRCT. This recommendation began with a classic 1999 article cause of shoulder pain: Ganglion cyst of the acromiocla- discussing 65 patients with tear size of 50% or more who were W 1 vicular joint. Ganglion cyst often induces severe pain and impairs treated with either arthroscopic acromioplasty alone or combined quality of life, even with multi-modal therapies. The ganglion cyst with mini-open rotator cuff repair.6 Although significant for the commonly develops along the tendons or joints. Ganglion cysts size of the cohort and follow-up, patients were not randomized to are typically round or oval shape and filled with a jellylike fluid. We acromioplasty versus repair, and there was no control group with- 1 1 appreciated the rare case report by Sarman et al.1 Sarman et al1 per- out repair. Thus, although the “50% rule” is commonly used to formed an image investigation to clarify the tissue content by an X- determine when root canal treatment (RCT) should be repaired, ray and an magnetic resonance imaging (MRI) examination. They the cutoff for a critical lesion is not well-defined. According to our found a 10×8×5 cm mass which was homogenous fluid contained experience, the acromio-humeral impingement which can be seen with a septum. And the lesion had several cysts in the T2 image. on the X-ray in abduction posture is a pain source in the shoulder Although, it looked like a benign lesion as the author described, a joint. Maybe treating the ganglion cyst only but left the rotator painful mass raised the alarm. The possibility of malignant change cuff alone was not sufficient for shoulder pain. We fully agree that is because of the lesion size which is bigger than 5 cm as well as a surgical excision improved the symptoms and function.
deep mass or one adhering to the fascia.2 Conversely, a mass that moves with the muscle tissues is probably superficial and less likely CONFLICT OF INTEREST to be malignant.3 The authors declare that they have no conflicts of interest. According to the X-ray, the acromion-humeral head in- terval was decreased, the humeral head was upper migrated, and