Rationale: Priapism is a common urologic emergency, but high-flow penile priapism (HFP) caused by trauma is very rare. Therefore, HFP diagnosis and treatment are still not standardized. Patient concerns: A 29-year-old man was admitted to the urology department of our hospital on August 01, 2019, due to “persistent penile erection caused by a straddle injury.” Diagnosis: On July 17, 2019, the patient underwent Doppler ultrasonography, which indicated swollen corpus cavernosum. Interventions: The patient took over-the-counter anti-inflammatory drugs but the erectile state of the penis remained unchanged. A second perineal injury resulted in hospital admission. Multimodality magnetic resonance imaging (MRI) scan showed nodular abnormal signals at the right corpus cavernosum root. Subsequently, selective arterial interventional angiography confirmed the MRI findings. Spring coils were then inserted for embolization, and the pseudoaneurysm, fistula, and priapism disappeared. Outcomes: Two months after surgery, sexual stimuli could normally cause penile erection, with normal hardness. The patient's sexual life returned to normal 3 months after surgery. Conclusion: Multimodality MRI is very effective in detecting high blood flow priapism. Its application would improve the clinical management of this ailment.

BACKGROUND Charcot neuroarthropathy (CN) is a systemic disease characterized by progressive bone loss and destruction, which is usually closely related to diabetes, HIV, etc. However, CN caused by syringomyelia accounts for only 5% of CN cases; the shoulder and elbow are most often involved, and the hip joint is rarely affected. As a rare factor, cervical spondylotic myelopathy (CSM) can be associated with syringomyelia, which is scarcely reported in the literature. Here, we present the first case report to date of CN of the hip caused by syringomyelia secondary to CSM. CASE SUMMARY We describe a 76-year-old male patient who was diagnosed with CSM due to neck pain and weakness of limbs 16 years ago. Four years ago, he noticed recurrent swelling of the right hip with pain and was diagnosed with degenerative arthritis. Recently, however, his symptoms gradually worsened, and because of progressive pain, destabilization and weakness of the right hip, he was admitted to our hospital. Through systematic physical, radiographic and laboratory examinations, we finally reached a diagnosis: CN of the right hip associated with syringomyelia secondary to CSM. After comprehensive evaluation of the patient's condition, we performed right total hip arthroplasty. During the follow-up, the patient felt well clinically and could walk independently with a knee brace. CONCLUSION We suggest a possible etiological association between CSM and syringomyelia, which may reflect a potential pathogenesis of CN. We encourage clinicians to actively carry out a detailed medical history and comprehensive physical and imaging examinations in patients with joint lesions, especially chronic shoulder neck pain, to rule out the possibility of this association, which plays a crucial role in the early diagnosis of CN. Arthroplasty may no longer be an absolute contraindication to surgical treatment of CN. Reasonable selection of the surgical strategy can markedly improve the clinical symptoms and quality of life of patients.