Neuropathic arthropathy caused by syringomyelia

Abstract

The elbow is the most frequently involved joint in neuropathic arthropathy caused by syringomyelia, followed by the shoulder. The authors speculate that the side of the syrinx determines the side of the neuropathic arthropathy. A detailed medical history and a careful physical examination are crucial for differentiating neuropathic arthropathy from other joint lesions. This study suggests that early management of the primary neurological condition may play an important role in preventing the development of neuropathic arthropathy and avoiding disease progression.

Charcot Elbow Joint as the Initial Symptom in Chiari Malformation with Syringomyelia

“…The severity of joint destruction and symptoms of patients are disproportionate. [ 1 ] Correspondingly, our patient displayed elbow deformity, the mild pain of left elbow, numbness on left ulnar two fingers without pain or tenderness in joint activity. Nevertheless, correct diagnosis of CJ needs further assistant examination due to nonspecific clinical manifestations.…”

Syringomyelia with Chiari I Malformation Presenting as Hip Charcot Arthropathy: A Case Report and Literature Review

“…In noncommunicating syringomyelia, the syrinx and dilated central canal do not communicate with the fourth ventricle, and the obstruction is usually located at or below the level of the foramen magnum [ 4 ]. The latter is the most common type of syringomyelia, found in approximately 50% of all cases, where CSF flow from the posterior fossa to the caudal space is blocked, and the most common underlying etiology is an Arnold-Chiari type I malformation [ 1 , 5 ]. Other common causes of syringomyelia include hindbrain anomalies, neoplastic disease, inflammatory conditions, and trauma [ 6 , 7 ].…”

“…Neuropathic osteoarthropathy (Charcot joint) caused by syringomyelia is rare and a commonly misdiagnosed disease. Of the few cases reported in literature, the upper extremity (wrist, elbow, and shoulder) joints remain the most common site of syringomyelia related arthropathies [ 1 , 2 , 24 – 26 ].…”

“…All patients who underwent neurosurgical treatment stated improvement in neurological dysfunctions and no deterioration in symptoms related to neuropathic arthropathy. No surgical management was performed on the neuropathic joints in any of their patients [ 1 ].…”

“…Neuroarthropathies reported in syringomyelia are rare and late complications of the disease, which often present as a monoarticular neuroarthropathy involving the upper extremities (shoulder and elbow joints) [ 1 , 2 ]. We herein report a very rare presentation of undiagnosed syringomyelia with Chiari I malformation where hip Charcot arthropathy represented an early manifestation of the patient's underlying disease.…”