PDF(Pubmed)
Abstract：
Syringomyelia is a prevalent cause of Charcot arthropathy, notably affecting the elbow and less frequently the shoulder. Before attributing neuropathic arthropathy (NA) to a syrinx, careful investigation of various potential causes is vital. We present a unique case of NA affecting the left shoulder, secondary to a longstanding syrinx presenting as an expansile mass on imaging, raising suspicion of malignancy. The patient presented with progressive left arm swelling, limited mobility, and a history of chronic left shoulder pain. Through clinical evaluation and imaging, including X-rays and CT scans, significant bone destruction and a large fluid-filled mass in the left shoulder were observed. Laboratory tests ruled out other potential diagnoses, and a bone biopsy excluded malignancy. This study emphasizes the importance of thorough differential diagnosis and appropriate imaging techniques to distinguish NA from other conditions. The diagnosis of NA relies on a comprehensive assessment involving clinical signs, symptoms, radiological imaging, and additional tests aimed at excluding other potential causes, including soft tissue tumors. Management strategies, including conservative approaches and surgical interventions like neurosurgical decompression and shoulder arthroplasty, are discussed. The study sheds light on the challenges in diagnosing and managing NA associated with syringomyelia and emphasizes the significance of a multidisciplinary approach for optimal outcomes.
摘要：
脊髓空洞症是Charcot关节病的主要原因,显著影响肘部和较少经常影响肩膀。在将神经病性关节病（NA）归因于syrinx之前，仔细调查各种潜在原因至关重要。我们提出了一个影响左肩的NA的独特案例，继发于长期在成像时表现为膨胀性物质的注射器，怀疑是恶性肿瘤.患者出现进行性左臂肿胀，流动性有限，有慢性左肩疼痛史.通过临床评估和影像学检查,包括X光和CT扫描,观察到左肩有明显的骨质破坏和大量充满液体的肿块。实验室检查排除了其他潜在的诊断,骨活检排除恶性肿瘤。这项研究强调了彻底鉴别诊断和适当的成像技术以区分NA与其他疾病的重要性。NA的诊断依赖于涉及临床体征的综合评估，症状,放射成像，以及旨在排除其他潜在原因的额外测试，包括软组织肿瘤.管理策略,包括保守的方法和手术干预，如神经外科减压术和肩关节成形术，正在讨论。该研究揭示了诊断和管理与脊髓空洞症相关的NA的挑战，并强调了多学科方法对最佳结果的重要性。
