Syringomyelic Neuropathic Arthropathy of the Elbow

Neuropathic Arthropathy or Charcot joint is a progressive, destructive arthritis that is associated with an underlying neurological disorder. We present a case of a 30 year-old male who, three years prior, had ruptured his right distal biceps tendon with subsequent development of a deep infection. At representation, the patient's clinical picture was consistent with the re-emergence of a deep elbow infection. Laboratory testing found no evidence of infection. Magnetic Resonance Imaging (MRI) of the patient's spine revealed a syringomyelia and a NA was diagnosed. The purpose of this report is to raise awareness of a unique presentation of a rare clinical condition in the early stages of the disease. Neuropathic Arthropathy (NA) is a rare disorder which typically affects the joints of the lower limb. Involvement of the upper limb is uncommon. Among patients with NA, the elbow joint is thought to be affected in only 3% of cases. NA of the elbow as a presenting symptom of syringomyelia is extremely rare. We describe a unique case of NA of the right elbow preceded by a septic arthritis of the same joint. The purpose of this case report is to raise awareness of an uncommon pathology in its early stages where outcomes may be influenced by early diagnosis and management.