Teaching Neuro Images : The Charcot shoulder

Abstract

A 39-year-old man presented with 1-year history of shoulder pain, swelling, and limitation of movement. There was a 20-year history of left shoulder and arm numbness. Examination showed decreased vibratory sensitivity on left shoulder, glenohumeral instability, and dislocation. Radiography showed humeral head destruction (figure 1); a spine MRI showed tonsillar herniation and cervical syringomyelia (figure 2). Arthropathy related to syringomyelia was diagnosed.Chiari type 1 malformation may be associated to syringomyelia, and may cause sensory loss.