Atypical joint involvement in neuropathic arthropathy secondary to syringomyelia: A case report

Neuropathic arthropathy (NA) is a chronic, progressive, destructive, aseptic inflammatory joint disorder resulting from sensory neurological deficit. We report a new case of NA with simultaneous involvement of the shoulder, elbow, and hands secondary to syringomyelia. Due to the rarity of this condition and its unusual location. The patient presented with painless deformation of both hands. Clinical examination revealed amyotrophy in both hands associated with hypoesthesia and bilateral areflexia of the upper limbs. The plain radiographs showed bone destruction and reconstruction in the metacarpophalangeal and interphalangeal joints, as well as obvious intra- and extra-articular bone debris in the elbows and the shoulders. Magnetic resonance imaging of the spinal cord revealed extensive syringomyelia in the cervical-thoracic region. This case demonstrates the role of imaging in the diagnosis of NA caused by syringomyelia; it is rare and poorly documented in the literature. Arthropathy of the hands is therefore extremely rare. This atypical condition should be considered particularly when it affects the upper limbs.