Neuropathic arthropathy caused by syringomyelia in different joints and lesion of brachial plexus at right upper extremity: A case report

Siringomyeli yavaş progresyon ile karakterizedir; en sık etkilenen eklemler omuz ve dirseklerdir. Elde nöropatik artropati oldukça nadirdir. Bu yazıda siringomyeliye sekonder nöropatik artropatisi (NA) bulunan bir olguyu sunmaktayız. Bu vakanın atipik özellikleri, aynı üst ekstremitede omuz, dirsek ve metakarpofalengeal eklemlerde NA varlığıdır. Bu atipik özellikler omuz subluksasyonu ve elektrofizyolojik çalışma ile ortaya konan brakiyal pleksopatinin üzerine eklenmiştir. Bizim bilgimize göre bu çalışma, yukarıda belirtilen semptomların hepsine sahip bir hastayı sunan ilk çalışmadır.

Anahtar Kelimeler:

Brakial pleksus, Siringomiyeli, Erkek, Artropati, nörojenik, Orta yaşlı

Siringomyeliye bağlı farklı eklemlerde nöropatik artropi ve sağ üst ekstiremitede brakiyal pleksus lezyonu: Olgu sunumu

Syringomyelia is characterized by slow progression; the joints involved most frequently are the shoulders and elbows. Neuropathic arthropathy of the hand is quite rare. Herewith, we present a case of neuropathic arthropathy (NA) of the joints in the upper limb secondary to Syringomyelia. Atypical features of the case included NA of the shoulder, elbow and metacarpophalengeal joint in the same upper limb. These atypical features superimposed shoulder subluxation and brachial plexopathy which diagnosed by electrophysiologic studies. To the best of our knowledge, our study is the first of its kind that reports a patient who had all the abovementioned symptoms in the same upper limb.

Keywords:

Brachial Plexus, Syringomyelia, Male, Arthropathy, Neurogenic, Middle Aged,

PDF

___

Aggarwal ND, Batra NM and Gupta AK: Study of synovial fluid in chronic arthritis with special reference to the presence of phagocytes.Ind. J. Surg 1975; 37: 202-207.
Barnett HJM, Foster JB and Hudgson P: "Syringomyelia". 1st Ed., W. B. Saunders Company, London, Philadelphia, and Toronto, 1973, pp. 11, 12, 29, 158, 167, 168.
Basu SP: Bone changes in leprosy. Ind. J. Radiol 1972; 26: 239-249.
Bhaskaran R, Suresh K, Iyer GV: Charcot's elbow (a case report). J Postgrad Med 1981; 27: 194-6.
Bruckner FE, Howell A: Neuropathic joints. Semin Arthritis Rheum 1972; 2: 47-9.
Delano PJ: The pathogenesis of Charcot's joint. Am J Rheum 1946; 56: 189-197.
de Sausa Neves F, Pereira Goncalves D, Roberto C: Syringomyelia, neuropathic arthropathy and rheumatoid arthritis as diagnostic dilemmas in two different cases: confounding factor and true coexistence. Clin Rheumatol 2005; 14: 1-3.
Drvaric DM, Rooks MD, Bishop A, Jacobs LH: Neuropathic arthropathy of the shoulder, a case report. Orthopedics 1988; 11: 301-4.
Finlayson A: Syringomyelia and related conditions. In Joynt RJ, ed. Clinical Neurology Vol. 3, JB Lippincott Company, Philadelphia, Chapter 45 1988, pp. 1-17.
Mancall E: Syringomyelia. In: Rowland LP, ed., Merritt’s textbook of neurology. Lea and Feibeger, Philad,elphia, 1984, pp. 552-6.
Peioglou-Harmoussi S, Fawcett PR, Howel D, Barwick DD: Fresponses in syringomyelia. J Neurol Sci 1986; 75: 293-304.
Singer GL, Brust JC, Challenor YB: Syringomyelia presenting as shoulder dysfunction. Arch Phys Med Rehabil. 1992; 73: 285-8.
Stendler A: Tabetic arthropathies. J. Amer. Med. Assoc 1931; 29: 250-256.
Tator CH, Briceno C: Treatment of syringomyelia with a syringosubarachnoid shunt. Can J Neurol Sci 1988; 15: 48-57.
Veilleux M, Stevens JC: Syringomyelia: electrophysiologic aspects. Muscle Nerve 1987; 10: 449-58.
Williams B: Syringomyelia. Neurosurg Clin North Am 1990; 1: 653-685.
Wisoff JH: Hydromyelia: a critical review. Childs Nerv Syst 1988; 4:1-8.