1/16. Destructive hip disease complicating traumatic paraplegia.Recent progress in the management of spinal cord injury has provided longer survivals, and as a result the incidence of secondary bone and joint disorders has increased. Joint lesions due to syringomyelia complicating a cervical spinal cord injury are the most common of these disorders. We report a case of destructive hip disease 7 years after an injury responsible for complete paraplegia with sensory loss. The joint lesions were painless, and there was no local evidence of inflammation. hip radiographs disclosed atrophic osteoarthropathy with complete destruction of the femoral neck and head. This unusual case raises questions about the pathophysiology of neuropathic osteoarthropathy in paraplegics.- - - - - - - - - - ranking = 1keywords = syringomyelia (Clic here for more details about this article) |
2/16. Neuropathic arthropathy of the elbow. A report of five cases.BACKGROUND: Neuropathic arthropathy of the elbow is rare and characterized by a painless but unstable articulation. The functional capacity of patients with this condition has not been reviewed in detail. methods: Five male patients, with an average age of fifty-one years, were treated for neuropathic arthropathy of the elbow. The underlying conditions associated with the arthropathy included syringomyelia, insulin-dependent diabetes mellitus, end-stage renal failure, and two cases of polyneuropathy of unknown cause. Four patients sought medical attention after a specific traumatic event. Peripheral sensory and motor dysfunction was present in each patient. Radiographs of the elbow revealed dislocation, fracture fragmentation, and heterotopic ossification. Our management of the neuropathic elbows centered on maintenance of a functional arc of motion through physical therapy aimed at regaining muscle strength and the use of orthoses for support. Operative treatment was performed for an associated ulnar or radial nerve compression syndrome in three patients, and an open reduction and internal fixation of an unstable proximal ulnar nonunion associated with loose implants was performed in one. RESULTS: The patients were followed for an average of nineteen months, with a range of twelve to thirty-six months. All patients had a pain-free elbow with a functional range of motion at the most recent follow-up examination, and none wished to have further treatment. The operatively treated ulnar nonunion united successfully. All three patients treated surgically for an associated nerve compression syndrome had recovery of nerve function. CONCLUSION: In the face of instability and gross distortion of the joint, the patients in this series demonstrated remarkably good function.- - - - - - - - - - ranking = 1keywords = syringomyelia (Clic here for more details about this article) |
3/16. Charcot joint-like changes following ankle fracture in a patient with no underlying disease: report of a rare case.Charcot joint is a disease that often occurs in patients with diabetes mellitus, tabes dorsalis, syringomyelia, chronic alcoholism, leprosy, trauma, or infection after fractures and dislocations. The treatment for Charcot joint has various complications, such as skin lesions, infections, and delayed union. We present our experience with a male patient who developed Charcot joint-like changes without diabetes mellitus or any other disease after an ankle fracture due to minor trauma.- - - - - - - - - - ranking = 1keywords = syringomyelia (Clic here for more details about this article) |
4/16. Neuropathic arthropathy caused by arnold-chiari malformation with syringomyelia.We report a case of neuropathic arthropathy caused by arnold-chiari malformation with syringomyelia, with details of the clinical and radiologic aspects. The patient had pain and stiffness in his left upper limb. MRI of the left shoulder revealed neuropathic arthropathy. Upon examination, his left elbow also had the characteristic findings for neuropathic arthropathy. Examination of the spinal cord by MRI confirmed arnold-chiari malformation associated with syringomyelia. Neuropathic arthropathy requires evaluation of the spinal cord to assess for occult causal lesions.- - - - - - - - - - ranking = 6keywords = syringomyelia (Clic here for more details about this article) |
5/16. axillary vein thrombosis as a manifestation of rapidly progressive neuropathic arthropathy of the shoulder associated with syringomyelia.Neuropathic arthropathy is a destructive joint disease associated frequently with loss of proprioception. syringomyelia (with or without arnold-chiari malformation) is characterized by slow progression over many years; the joints involved most frequently are the shoulders and elbows. Neuropathic arthropathy of the hand is rare, and clinical features are vasomotor problems, digital ulcers, thickening of the fingers, and painless subluxation of the finger joints. We report an unusual case of neuropathic arthropathy of the shoulder and hands, associated with syringomyelia without arnold-chiari malformation. Neuropathic arthropathy of the shoulder was rapidly progressive, and axillary vein thrombosis was the first manifestation; however, neuropathic arthropathy of the hands was unrecognized for 7 years, and painless ulceration of the fingers with spontaneous amputation of the terminal phalanx and Raynaud phenomenon were the initial manifestations. To our knowledge, this is the first report of a patient with this constellation of findings.- - - - - - - - - - ranking = 5keywords = syringomyelia (Clic here for more details about this article) |
6/16. Orthopaedic features in the presentation of syringomyelia.The orthopaedic surgeon is often the first consultant to whom a patient with syringomyelia is referred. The disease is not as rare as he may suppose, but its early presenting features are very variable; if he relies solely on such familiar features as pes cavus and scoliosis, he may well miss the diagnosis. The commonest presenting symptom is pain in the head, neck, trunk or limbs; headache or neckache made worse by straining is particularly significant. A history of birth injury also may suggest the possibility of syringomyelia, especially if any spasticity subsequently worsens. Neurological features which may be diagnostic include nystagmus, dissociated sensory loss, muscle wasting, spasticity of the lower limbs or Charcot's joints. Radiographic features include erosion of the bodies of cervical vertebrae and widening of the spinal canal; if, at C5, the size of the canal exceeds that of the body by 6 millimetres in the adult, pathological dilatation is present. The presence of basilar invagination or other abnormalities of the foramen magnum, of spina bifida occulta and of scoliosis are further pointers. thermography is a useful way of showing asymmetrical sympathetic involvement in early cases. A greater awareness of the prevalence of syringomyelia may lead to earlier diagnosis and to early operation, which appears to hold out the best hope of arresting what is all too commonly a severely disabling and progressive condition.- - - - - - - - - - ranking = 7keywords = syringomyelia (Clic here for more details about this article) |
7/16. Pseudoseptic arthritis: an unusual presentation of neuropathic arthropathy.A 49 year old black man with scoliosis presented with bilateral shoulder swelling eventually shown to be due to neuropathic arthropathy related to underlying syringomyelia. The synovial fluid was highly inflammatory, but cultures from synovial fluid and synovial tissue were all sterile. Profuse fat droplets were noted and considered as a possible cause of the inflammation. This is an unusual presentation of neuropathic arthropathy in a patient who was also harbouring an adenocarcinoma that was undetected until later.- - - - - - - - - - ranking = 1keywords = syringomyelia (Clic here for more details about this article) |
8/16. Spinal neuroarthropathy after traumatic paraplegia.Spinal neuroarthropathy is a little-known complication of traumatic paraplegia. Four cases of this syndrome are described, with emphasis on the characteristic radiographic findings of severe juxta-articular bone destruction, dense appositional new bone formation, large osteophytosis, and soft-tissue bony debris. The factors predisposing patients to develop a neuropathic joint are diminished pain and proprioceptive sensations with maintained mobility. When a paraplegic patient transfers in or out of a wheelchair or moves his upper torso, he exerts force on an insensate spine. Repeated trauma increases joint mobility beyond the normal limits, and this leads to further damage, with the process culminating in severe instability and bone destruction. The other causes of neuropathic joints in the spine--tertiary syphilis, syringomyelia, and diabetes--must be ruled out on clinical grounds. Neuropathic changes in the spine are often silent, delaying treatment, or may be mistaken for infection or degenerative disease. Their true prevalence is difficult to determine, but the possibility should be considered in paraplegic patients with the characteristic radiographic findings.- - - - - - - - - - ranking = 1keywords = syringomyelia (Clic here for more details about this article) |
9/16. Neuropathic sternoclavicular joint secondary to syringomyelia. A case report.A 14-year-old boy is presented with syringomyelia and a neuropathic sternoclavicular joint. Recognition of neuropathic arthropathy of the upper extremity is important when a massive, destructive joint lesion exists in a patient with syringomyelia.- - - - - - - - - - ranking = 6keywords = syringomyelia (Clic here for more details about this article) |
10/16. Neuropathic arthropathy of the shoulder. A case report.A case of neuropathic arthropathy of the shoulder secondary to syringomyelia is presented. The classic clinical and radiographic features of the entity are illustrated. Emphasis is made on the use of magnetic resonance imaging in evaluation. Neuropathic arthropathy should be considered in the evaluation of shoulder pain or instability.- - - - - - - - - - ranking = 1keywords = syringomyelia (Clic here for more details about this article) |
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