Hernigou Jacques, Boulares Sofiane, Delahaut Olivier
Acta Orthop Belg. 2018 Mar;84(1):73-77.
Neuroarthropathy or Charcot disease is a destructive joint pathology. Upper limb involvement is unusual and often due to syringomyelia. We reported a patient with spontaneous posterior right shoulder dislocation. Thereafter, she presented a quick joint destruction evoking a Charcot shoulder disease after excluding infectious and rheumatologic diseases. Explorations of this Charcot disease lead to the discovery and treatment of syringomyelia. A conservative management of her shoulder neuro-arthropathy has been proposed to the patient. Shoulder involvement in Charcot disease is unusual: only 5% of cases. 18 cases have been reported in English literature. Two theories try to explain Charcot disease: neuro-vascular and neuro-traumatic. There is no efficient treatment for Charcot shoulder disease but it can be prevented by surgical treatment of syringomyelia. Charcot shoulder is a rare and morbid disease for which conservative treatment is recommended because of disappointing results of arthroplasty and arthrodesis.
神经性关节病或夏科氏病是一种破坏性关节病变。上肢受累情况不常见，且往往由脊髓空洞症引起。我们报告了一例自发性右肩关节后脱位患者。此后，在排除感染性和风湿性疾病后，她迅速出现关节破坏，引发了夏科氏肩关节病。对该夏科氏病的检查发现并治疗了脊髓空洞症。已向患者提出对其肩部神经性关节病进行保守治疗。夏科氏病累及肩部的情况不常见：仅占病例的5%。英文文献中已报道了18例。有两种理论试图解释夏科氏病：神经血管学说和神经创伤学说。对于夏科氏肩关节病尚无有效的治疗方法，但可通过脊髓空洞症的手术治疗来预防。夏科氏肩关节病是一种罕见且病情严重的疾病，由于关节成形术和关节融合术效果不佳，建议采用保守治疗。
