Neuropathic arthropathy of the shoulder associated with syringomyelia: a report of six cases

Abstract

Here, we report a series of 5 patients (6 shoulders) diagnosed with neuropathic arthropathy of the shoulder joint in our clinic between 2005 and 2008. Initial diagnosis, previous treatment, and radiological and clinical follow-up findings were reviewed. The mean age at diagnosis was 44.2 years. Four patients had unilateral and 1 patient had bilateral involvement. The presenting symptoms were pain, swelling, and loss in range of motion. Active forward flexion and abduction ranged from 0° to 90°. Hypoesthesia and loss of temperature sense was evident in 3 patients. Radiographs showed massive osteolysis of humeral head and glenoid process, and magnetic resonance imaging showed periarticular fluid collection, and degeneration at the rotator cuff and shoulder joint, resembling chronic septic arthritis or sarcoma. Biopsy was performed in 4 patients before definitive diagnosis, and synovial hypertrophy and necrotic bone was found. Two patients had a history of operated cervical syringomyelia, and the remaining 3 patients were later diagnosed to have syringomyelia and referred to neurosurgery clinic, where 2 of those were operated. Four patients were followed-up with symptomatic therapy, and 1 patient underwent an unsuccessful shoulder arthroplasty in another clinic. As a conclusion, neuropathic arthropathy of the shoulder is rare, and correct diagnosis is possible by careful physical and neurological examination and pathologic evaluation when needed.

Regrowth of the deteriorated glenoid in advanced Charcot shoulder after suboccipital decompression for syringomyelia: a case report

“…6 Atalar et al described 5 Charcot shoulder patients (6 shoulders); 4 shoulders treated by conventional methods showed no improvement in range of motion, whereas improvement was obtained by suboccipital decompression in 2 shoulders. 2 In the present case, not only did we obtain good function of the shoulder joint after suboccipital decompression, but we also observed marked bone regrowth. According to our research of the literature, this is the first case of active bone regrowth in Charcot shoulder.…”

Bilateral Neuropathic Osteoarthropathy of the Shoulder due to Syringomyelia

“… 8 , 10 Atalar et al , in a case series of 6 patients with Charcot opsteoarthropathy, 5 of them have got a diagnosis of malignity and one of them was diagnosed as septic arthritis at the beginning. 11 In a similar study, Chakraborty et al proposed the diagnosis as a stress fracture due to osteomalasia at first but changed it as…”

A Case of Missed Unilateral Neuropathic Arthropathy of the Shoulder Secondary to Cervico - Dorsal Syrinx : A Rare Presentation

“…The variable options tried but without success include arthrodesis, synovectomy and alendronate therapy during the resorptive phase. Mainstay of conservative treatment is aspiration of effusion and splinting as required (Ata Can Atalar ET al, 3 Ashok Panagariya ET al 4 ). It is largely misinterpreted due to the unusual ways of presentation.…”