387 Neuropathic Arthropathy Caused by Syringomyelia in Different Joints and Lesion of Brachial Plexus at Right Upper Extremity: A Case Report

Ekim, Ayşe; Armağan, Onur; Oner, Cengiz

doi:10.1016/s1090-3801(06)60390-x

Cited by 6 publications

(17 citation statements)

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“…The joints most frequently affected are the weight-bearing joints, predominantly the mid-foot and then ankle [ 4 ], knee, hip and rarely the spine [ 5 ] and upper extremity, especially seldom in hands [ 6 ]. The involved joints are partly dependent on the underlying neurological condition such as foot and ankle in diabetes [ 7 ], knees in tabes dorsalis [ 8 ], upper extremity joints in syringomyelia [ 9 ] and hand in syringomyelia [ 10 ]. However, the cases reported in individuals with SCI were commonly in the spine know as Charcot spine arthropathy [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Case series on the Charcot neuroarthropathy in hands after cervical central cord syndrome

Wang

Tong

Liu

et al. 2022

BMC Musculoskelet Disord

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Background Charcot neuroarthropathy (CNA) of the upper extremity occurs most frequently in shoulders. However, CNA in the hands is uncommon and seldom be reported. The onset of CNA is usually insidious. If this process continues undetected, it can result in joint deformity, ulceration and/or superinfection, loss of function, and amputation or even death. In this article, we are going to present three cases of CNA in the hands of individuals with cervical spinal cord injury (SCI) with central cord syndrome. Case presentation Three male individuals with cervical spinal stenosis contracted tetraplegia (American Spinal Injury Association Impairment Scale Grade D, D, and B) due to spinal cord contusion after a trauma and developed hand swelling without pain 2 to 3 months after their SCI. X-ray showed degenerative joint changes in the hands. CNA was considered due to the patient’s history of cervical SCI, loss of motor function and sensation, symptoms of painless swelling, physical examination, and X-ray findings. The self-care sub scores of Spinal Cord Independence Measure III improved slightly only during rehabilitation and follow-up due to poor hand function. Conclusions CNA may develop after a central or peripheral neurological disorder. Nearly every joint of the body can be affected and the lower limbs are the most frequently involved. However, CNA of the hand is rare. We present three patients with CNA in the hands after cervical SCI and review the features and early differential diagnosis of CNA. Currently there is no specific treatment available. Therefore, early identification of CNA and adequate protection to the affected joints seem important.

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Section: Discussionmentioning

confidence: 99%

Case series on the Charcot neuroarthropathy in hands after cervical central cord syndrome

Wang

Tong

Liu

et al. 2022

BMC Musculoskelet Disord

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“…Additionally, involvement of the wrist and hand joints as well as isolated ulnar neuropathies have been reported in some cases in the literature. [3,[8][9][10] Upper and lower motor neuron lesions associated with syringomyelia may lead to arthropathy, which frequently involves the weight-bearing joints of the body. Central sensorial lesions can be caused by multiple sclerosis (MS), syringomyelia, tabes dorsalis, leprosy, congenital lack of response to the pain, cerebral palsy, or a spinal cord injury, whereas peripheral sensorial lesions are caused by DM, alcoholism, infections, poliomyelitis, pernicious anemia, or amyloidosis.…”

Section: Discussionmentioning

confidence: 99%

“…It may also cause multiple joint exposures in the elbows and hands. [3][4][5] In tabes dorsalis, diabetes mellitus (DM), alcoholic neuropathy, leprosy, syphilis, myelomeningocele, syringomyelia, and intra-articular steroid injections are the other causes of Charcot arthropathy. [1,2,6,7] Our case is interesting because of the symptoms which occurred in the later period of the disease, the comorbidity of acral mutilations, the existence of Charcot arthropathy in the shoulder and elbow, and the association with sensory motor polyneuropathy.…”

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confidence: 99%

A Pre- and Postoperative Evaluation of Multiple Joint Involvement as the Initial Finding of Cervical Syringomyelia and Neuropathic Arthropathy

Kısabay¹

2013

Turk J Rheumatol

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Siringomiyeli spinal kordun içerisinde longitudinal kistin oluştuğu, progresif dejeneratif bir hastalıktır. En sık omuz eklem tutulumu görülen bu hastalığın ilerleyen dönemlerinde nöropatik artropati gelişimi söz konusudur. Bu yazıda, siringomiyeli, ArnoldChiari Sendromu ve nöropatik artropati tanısı konulan 42 yaşında kadın bir olgu sunuldu. Hastanın ilk yakınmaları olarak sağ omuzda ve dirsekte ağrısız ödem, parmak uçlarında yara ve amputasyonlar vardı. Hasta siringomiyeli ameliyatı öncesi ve sonrası değerlendirildi. Yavaş ilerleyen spinal kord lezyonlarında ilk bulgu olarak nöropatik artropatinin çıkabileceği göz önünde bulundurulmalıdır.Anahtar sözcükler: Arnold-Chiari Sendromu; nöropatik artropati; siringomyeli.Syringomyelia is a progressive, degenerative disorder, in which a longitudinal cyst forms within the spinal cord. Neuropathic arthropathy can be seen in the late phases of the disease, with the most frequent involvement being in the shoulder. Herein, we present a 42-year-old female case who was diagnosed with syringomyelia as well as Arnold-Chiari Syndrome and neuropathic arthropathy. Her initial complaints were painless edema in the right shoulder and elbow, wounds on the tips of her fingers and amputations. She was evaluated both pre-and postoperative periods. It should be kept in mind that neuropathic arthropathy may develop as the initial symptom in spinal cord lesions which progress slowly.

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“…Weakness and paresthesias were also observed and EMG analysis showed denervation patterns of upper trunk brachial plexopathy. Brachial plexopathy was described in two patients with Charcot shoulders but was attributed to recurrent shoulder subluxation causing irritation of the neural elements of the brachial plexus (Singer et al, ; Ekim and Armagan, ). Nerve compression due to Charcot arthropathy at other joints has rarely been reported (Deirmengian et al, ).…”

Section: Discussionmentioning

confidence: 99%

Charcot arthropathy of the shoulder associated with typical and atypical findings

et al. 2012

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We present a patient with a relatively rare condition: Charcot joint of the shoulder, with a rare complication, the first known example of combined neurovascular compression in this location. A 49-year-old man presented with neuropathic arthropathy of the shoulder caused by syringomyelia from a Chiari I malformation, leading to compression of both the brachial plexus and the axillary vein by mass effect from the synovitis. The brachial plexopathy resolved with surgical decompression and synovectomy, and the syringomyelia stabilized after Chiari decompression. A large acromioclavicular joint synovial cyst developed as a late complication, which was treated nonoperatively. Understanding neuropathic arthropathy can explain the spectrum of interrelated typical and atypical features in this case over long-term follow-up.

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387 Neuropathic Arthropathy Caused by Syringomyelia in Different Joints and Lesion of Brachial Plexus at Right Upper Extremity: A Case Report

Cited by 6 publications

References 0 publications

Case series on the Charcot neuroarthropathy in hands after cervical central cord syndrome

Case series on the Charcot neuroarthropathy in hands after cervical central cord syndrome

A Pre- and Postoperative Evaluation of Multiple Joint Involvement as the Initial Finding of Cervical Syringomyelia and Neuropathic Arthropathy

Charcot arthropathy of the shoulder associated with typical and atypical findings

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