Neuroarthropathy of the shoulder of unexpected origin

The authors describe the case of a 65-year-old woman who developed a sudden and painless palsy of right shoulder one month after a benign fall. Radiographs showed severe articular destruction. Neurologic examination revealed only a mild sensory loss of the right upper extremity. A diagnosis of syringomyelia was evoked and confirmed by spinal MRI. An upper extremity neuroarthropathy is usually caused by syringomyelia and is sometimes the first and leading symptom of this disease. Sensory neuropathy explains the incidence of this often painless osteoarthropathy. Treatment with bisphosphonate is discussed.