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Orthopaedic features in the presentation of syringomyelia
The Journal of Bone and Joint Surgery. British Volume
|August 1, 1979
Summary
Syringomyelia is a neurological disorder that may present with varied symptoms, including pain and neurological deficits. Early recognition by orthopaedic surgeons is crucial for timely intervention and improved outcomes.
Area of Science:
- Neurology
- Orthopaedics
- Radiology
Background:
- Syringomyelia is a rare neurological condition.
- Orthopaedic surgeons are often the first specialists to see patients with this condition.
Observation:
- Early symptoms of syringomyelia are highly variable and can be missed if relying only on classic signs like pes cavus and scoliosis.
- Common symptoms include pain (head, neck, trunk, limbs), headache or neckache worsened by straining, and a history of birth injury.
- Diagnostic neurological signs include nystagmus, dissociated sensory loss, muscle wasting, lower limb spasticity, and Charcot's joints.
Findings:
- Radiographic findings suggestive of syringomyelia include cervical vertebral erosion, spinal canal widening (pathological dilatation at C5 if canal width exceeds body width by 6mm in adults), basilar invagination, foramen magnum abnormalities, spina bifida occulta, and scoliosis.
- Thermography can reveal asymmetrical sympathetic involvement in early stages.
Implications:
- Increased awareness of syringomyelia's prevalence can lead to earlier diagnosis.
- Early surgical intervention offers the best hope for arresting this progressive and disabling condition.