Neuropathic Arthropathy of the Shoulder*

Hatzis, Nick; Kaar, T. K.; Wirth, Michael A.; Toro, Felipe; Rockwood, Charles A.

doi:10.2106/00004623-199809000-00010

Cited by 69 publications

(44 citation statements)

References 16 publications

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“…After swelling and pain, stiffness and decreased range of movement were the most frequent presenting symptoms. 5 In this case, there was swelling, pain and decreased range of movement. As we have seen the joint in question underwent a rapidly progressive destructive arthropathy.…”

Section: Discussionmentioning

confidence: 76%

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Delayed presentation of neuropathic arthropathy of shoulder secondary to syringomyelia

2005

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Section: Discussionmentioning

confidence: 76%

“…Meyer et al stated that 25% of patients with syringomyelia develop neuropathic arthropathies, 80% of which involve the upper limb. 5 Neuropathic arthropathy of the shoulder can present in a dramatic fashion. There is often extensive and rapid destruction of the proximal humerus and the glenoid.…”

Section: Discussionmentioning

confidence: 99%

Delayed presentation of neuropathic arthropathy of shoulder secondary to syringomyelia

2005

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“…6) A standard treatment for neuropathic arthropathy has consisted of conservative measures such as the use of non-weight bearing brace for the immobilization of joints. A study by Hatzis et al 7) have suggested that with regards to the treatment of neuropathic shoulder arthropathy maintaining shoulder joint function takes precedence over fixation through arthrodesis. In line with this, Matsuhashi et al 8) proposed that a favorable treatment of neuropathic arthropathy secondary to cervical syringomyelia is to surgically decompressed the syrinx and to repair rotator cuff through hemiarthroplasty; 3 patients who received a rotator cuff repair and a shoulder hemiarthroplasty showed good shoulder function and a preserved component at the 10-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

Neuropathic Arthropathy of the Shoulder Associated with Cervical Syringomyelia: A Case Report

Park¹,

Im²,

Moon³

et al. 2015

Clinics in Shoulder and Elbow

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Neuropathic shoulder arthropathy or Charcot's shoulder is an extremely rare disease, and sometimes it is associated with cervical syringomyelia. Clinical symptoms of the disease include edema of the shoulder and restriction in range of motion. Radiological diagnosis can be made through plain radiography through a characteristic, atrophic destruction of the joint. We experienced a Charcot's joint of the shoulder wherein destruction of the joint progressed extremely quickly and reviewed the literature concerning this condition. Correspondence to: Yongbeom Lee Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea Tel: +82-31-380-3770, Fax: +82-31-380-4118, E-mail: drleeyb@naver.com Charcot's joint is an extremely uncommon disease, and it is infrequently associated with cervical syringomyelia. A quarter of patients with cervical syringomyelia have been shown to have concomitant neuropathic arthropathy, 5% to 6% of which occur in the shoulder.1) The number of reported cases of this disease is very few and those existing are cited in the international literature; the Korean literature has yet to report of a case. The clinical symptoms of the disease include restriction in shoulder range of motion (ROM) and cellulitis associated with hypoesthesia or with edema. The authors encountered a patient whose Charcot's joint of a shoulder and joint destruction proceeded at an extremely fast pace. We report this case along with a review of the literature concerning this disease. Case ReportA male patient aged 44 years had suffered from restriction in ROM and severe swelling a week previous to his admission to hospital. The patient has a history of a 4th thoracic vertebral fracture 20 years ago for which he received conservative management and a history of syringomyelia 11 years ago. For the treatment syringomyelia the patient had received, at a different hospital, surgical treatment. The postoperative hypoesthesia of the bilateral upper limbs and paralysis of the lower body he sustained permanently meant that the patient has had to live with the aid of a wheelchair.The patient had a medical history of a suspected cellulitis of the same shoulder 4 months previous to the current visit, for which the patient had been given oral antibiotics. The patient's symptoms improved with medication. Four months later, the patient complained of mild pain around the shoulders. With physical examination, we found that the right shoulder presented with severe swelling and focal flaring, causing us to suspect septic ar- , and an internal rotation to the 1st lumbar spine. The results of blood tests taken at the time of admission were higher than normal: a white blood cell count of 9,100 cells/cm 2 , an erythrocyte sedimentation rate of 67 mm/h, and a C-reactive protein level of 20.2 mg/d. In addition, the plain radiography of the right shoulder showed osteopenia of the humeral head, destructive changes of the glenohumeral joint, and intra-and extra-articular detachmen...

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“…80% of syringomyelia related arthropathies involve the upper extremities, affecting commonly shoulder joint followed by the elbow and wrist. 2 It mostly involves single joint, however, there are reports of simultaneous involvement of shoulder, elbow and/or metacarpophalengeal joints. 3 It may be the first clinical manifestation of syringomyelia similar to our case.…”

Section: Discussionmentioning

confidence: 99%