Published online Dec 16, 2015. doi: 10.12998/wjcc.v3.i12.1017
Peer-review started: May 4, 2015
First decision: July 10, 2015
Revised: September 8, 2015
Accepted: October 16, 2015
Article in press: October 19, 2015
Published online: December 16, 2015
Processing time: 218 Days and 16.6 Hours
Neuropathic arthropathy of the shoulder is a rare disorder characterized by joint degeneration, and is associated with loss of sensory innervation. Syringomyelia is a disease in which fluid-containing cavities (syrinxes) form within the spinal cord. Here, we report a case of neuropathic arthropathy of the shoulder secondary to syringomyelia in a 40-year-old woman. X-rays of the left shoulder revealed damage to bone and joint architecture. Blood tests indicated vitamin D deficiency and secondary hyperparathyroidism. Magnetic resonance imaging of the cervical spine showed a large syrinx from the second cervical spine to the second dorsal spine. Although neuropathic arthropathy is uncommon, it should be considered in cases of unexplained pain, discomfort, or limited range of motion of the affected joint. Symptoms related to the affected joint may precede or overshadow neurological deficits. Appropriate radiological examinations and diagnoses are imperative to prevent misdiagnosis or undetected bone and joint disorders.
Core tip: Neuropathic arthropathy, also called Charcot shoulder, is a chronic, degenerative condition associated with decreased sensory innervation. Syringomyelia patients typically suffer with shoulder and elbow involvement. Since joint symptoms often appear before other signs, neurological deficits are often overshadowed, and the condition is misdiagnosed. In cases of unexplained joint pain, discomfort, and limited range of motion, syringomyelia should always be considered even in the absence of detectable neurological features. To prevent misdiagnoses, clinicians should be aware of the clinical and radiological signs of this rare condition. Timely diagnoses are important to avoid unwanted operative procedures that could lead to unsatisfactory outcomes.