Neuropathic arthropathy caused by syringomyelia

Area of Science:

• Neurology
• Orthopedics
• Neurosurgery

Background:

• Neuropathic arthropathy, or Charcot joint, is a rare condition often caused by syringomyelia.
• This condition is frequently misdiagnosed, with limited reporting by neurosurgeons.
• Understanding its presentation and the impact of neurosurgical intervention is crucial.

Purpose of the Study:

• To analyze the clinical and imaging features of neuropathic arthropathy secondary to syringomyelia.
• To evaluate the effect of surgical management of primary neurological deficits on the progression of neuropathic arthropathy.

Main Methods:

• Retrospective review of 12 patients with syringomyelia-associated neuropathic arthropathy treated between 2003 and 2012.
• Clinical and radiographic data analyzed, including MRI findings (syrinx, Chiari malformation, tethered cord).
• Surgical intervention focused on neurological deficits; no direct joint surgery performed. Follow-up averaged 39 months.

Main Results:

• Elbows (10) and shoulders (3) were the most affected joints.
• Five patients undergoing neurosurgery showed neurological improvement and no worsening of arthropathy.
• Seven patients without neurosurgery experienced arthropathy worsening (5/7), with neurological decline in 4.

Conclusions:

• Elbow and shoulder joints are most commonly affected by neuropathic arthropathy in syringomyelia.
• The side of the spinal cord syrinx may correlate with the affected limb.
• Early management of the underlying neurological condition is vital for preventing and managing neuropathic arthropathy.