Abstract：
Neuropathic arthropathy (NA) of the shoulder is a chronic progressive process characterized by joint destruction in the presence of a neurosensory deficit. Syringomyelia, a spinal cord disease, is the leading cause of NA in the upper extremity.
We present a systematic review of NA with syringomyelia cases alongside a case report of an adult with NA of the shoulder that occurs a few 4 years after a revelation and surgical management of a Chiari malformation with syringomyelia.
A systematic review was conducted following PRISMA guidelines. A PubMed, Scopus, Isiknowledge, and manual search through references of relevant publications were used to identify all published case reports of NA. Data were collected from each case report on patient characteristics.
The systematic review identified 56 publications and 85 patients (including ours): nearly the same number of males (n = 41) and females (n = 44). The mean age was 50,69. Presentations included reduction of mobility (n = 66), swelling (n = 61) and sensory disorder (n = 63). The pain was absent in 41 cases. In the majority of reported cases 56 (65.1%), syringomyelia was revealed by neuropathic arthropathy, and eleven patients (12.9%) had a history of syringomyelia. Treatment was categorized into non-operative management (37[43.5%]), operative management (27[31.7%]). Following-up was non-reported in 31 (36%) cases. Improvement was reported more with patients who underwent a surgical approach than medical one 28.5% versus 8.1%.
Physicians need to be more aware of this destructive joint disease, rare, and often misdiagnosed. Also, it is imperative to integrate clinical, pathological, and imaging findings for accurate diagnosis and for delivering appropriate therapy.
We present a systematic review of NA with syringomyelia cases alongside a case report of an adult with NA of the shoulder that occurs a few 4 years after a revelation and surgical management of a Chiari malformation with syringomyelia.
A systematic review was conducted following PRISMA guidelines. A PubMed, Scopus, Isiknowledge, and manual search through references of relevant publications were used to identify all published case reports of NA. Data were collected from each case report on patient characteristics.
The systematic review identified 56 publications and 85 patients (including ours): nearly the same number of males (n = 41) and females (n = 44). The mean age was 50,69. Presentations included reduction of mobility (n = 66), swelling (n = 61) and sensory disorder (n = 63). The pain was absent in 41 cases. In the majority of reported cases 56 (65.1%), syringomyelia was revealed by neuropathic arthropathy, and eleven patients (12.9%) had a history of syringomyelia. Treatment was categorized into non-operative management (37[43.5%]), operative management (27[31.7%]). Following-up was non-reported in 31 (36%) cases. Improvement was reported more with patients who underwent a surgical approach than medical one 28.5% versus 8.1%.
Physicians need to be more aware of this destructive joint disease, rare, and often misdiagnosed. Also, it is imperative to integrate clinical, pathological, and imaging findings for accurate diagnosis and for delivering appropriate therapy.
摘要：
肩关节的神经性关节病（NA）是一种慢性进行性过程，其特征是在存在神经感觉缺陷的情况下发生关节破坏。脊髓空洞症,脊髓疾病，是上肢NA的主要原因。
我们对伴有脊髓空洞症的NA病例进行了系统的综述，并报道了一名成人肩关节NA的病例报告，该病例报告发生在Chiari畸形伴有脊髓空洞症的手术治疗和手术治疗后4年。
按照PRISMA指南进行了系统评价。PubMed,Scopus,Isiknowledge,并通过相关出版物的参考文献进行人工搜索，以识别所有已发表的NA病例报告。从每个病例报告中收集有关患者特征的数据。
系统评价确定了56篇出版物和85名患者（包括我们的患者）：几乎相同数量的男性（n=41）和女性（n=44）。平均年龄为50,69岁。演讲包括流动性降低(n=66)，肿胀（n=61）和感觉障碍（n=63）。41例患者无疼痛。在大多数报告的病例中，56例(65.1%)，脊髓空洞症是由神经病性关节病发现的，11例患者(12.9%)有脊髓空洞症病史。治疗分为非手术治疗（37[43.5%]），手术管理（27[31.7%]）。31例(36%)未报告随访情况。据报道，接受手术治疗的患者的改善程度高于医疗方法的28.5％对8.1％。
医生需要更加了解这种破坏性的关节疾病，罕见,经常被误诊。此外，整合临床势在必行，病态,和影像学检查结果，以便准确诊断和提供适当的治疗。
我们对伴有脊髓空洞症的NA病例进行了系统的综述，并报道了一名成人肩关节NA的病例报告，该病例报告发生在Chiari畸形伴有脊髓空洞症的手术治疗和手术治疗后4年。
按照PRISMA指南进行了系统评价。PubMed,Scopus,Isiknowledge,并通过相关出版物的参考文献进行人工搜索，以识别所有已发表的NA病例报告。从每个病例报告中收集有关患者特征的数据。
系统评价确定了56篇出版物和85名患者（包括我们的患者）：几乎相同数量的男性（n=41）和女性（n=44）。平均年龄为50,69岁。演讲包括流动性降低(n=66)，肿胀（n=61）和感觉障碍（n=63）。41例患者无疼痛。在大多数报告的病例中，56例(65.1%)，脊髓空洞症是由神经病性关节病发现的，11例患者(12.9%)有脊髓空洞症病史。治疗分为非手术治疗（37[43.5%]），手术管理（27[31.7%]）。31例(36%)未报告随访情况。据报道，接受手术治疗的患者的改善程度高于医疗方法的28.5％对8.1％。
医生需要更加了解这种破坏性的关节疾病，罕见,经常被误诊。此外，整合临床势在必行，病态,和影像学检查结果，以便准确诊断和提供适当的治疗。
