Parida Manoj Kumar, Pattanaik Sarit Sekhar, Panda Aditya Kumar, Das Bidyut Kumar, Tripathy Saumya Ranjan
Department of Clinical Immunology and Rheumatology, SCB Medical College and Hospital, Cuttack, Odisha, India, 753007.
Department of Bioscience and Bioinformatics, Berhampur University, Berhampur, Ganjam, Odisha, India.
Clin Rheumatol. 2023 Jan;42(1):261-268. doi: 10.1007/s10067-022-06332-7. Epub 2022 Aug 22.
Syringomyelia is an important etiology of Charcot arthropathy of the elbow. We present five interesting patients, along with a systematic literature review summarizing the clinical profile and management of syringomyelia-induced Charcot arthropathy of the elbow. PUBMED, SCOPUS, EMBASE, and Science Direct databases were screened for English articles published between 1980 and 2022 using the search query: "Syringomyelia" AND "elbow" AND ("arthropathy" OR "neuropathic" OR "Charcot"). Articles without full text and/or lack of conclusive evidence of elbow arthropathy due to syringomyelia were excluded. The reference lists of the selected articles were reviewed to identify additional articles describing syringomyelia-induced Charcot arthropathy of the elbow. All five patients in the current series had elbow arthritis with variable motor weakness and dissociated sensory loss. The literature review included 31 reports (45 patients) and five patients from our center (n = 50). The median age at presentation was 45 (13-77) years. The median duration of arthropathy was 24 (0.5-180) months. Thirty-three patients had isolated elbow arthropathies. The other joints affected included the shoulder (n = 13), wrist (n = 7), metacarpophalangeal joints (n = 3), and interphalangeal joints (n = 1). Chiari malformations were present in 33 (66%) patients. Sensory deficits, motor deficits, and ulnar neuropathies were described in 36 (72%), 31 (62%), and 14 (28%) patients, respectively. Surgical decompression for syringomyelia was performed in 13 (26%) patients. The presence of dissociated sensory loss, with or without motor weakness, is key to the suspicion of syringomyelia-induced Charcot arthropathy of elbow. Chiari malformation and ulnar neuropathy are frequently associated with this condition. Key Points • Charcot arthropathy of elbow is not so uncommon as believed • Syringomyelia is an important etiology of Charcot arthropathy of elbow • Therefore, all patients with elbow arthropathy of unknown etiology must be evaluated for dissociative sensory loss • Chiari malformation and ulnar neuropathy are commonly associated with syringomyelia-induced Charcot arthropathy of elbow joint.
脊髓空洞症是肘部夏科关节病的一个重要病因。我们报告了5例有趣的患者，并进行了系统的文献综述，总结了脊髓空洞症所致肘部夏科关节病的临床特征及治疗方法。通过搜索查询词：“脊髓空洞症”、“肘部”以及（“关节病”或“神经性的”或“夏科”），对1980年至2022年间发表在PUBMED、SCOPUS、EMBASE和Science Direct数据库中的英文文章进行筛选。排除无全文和/或缺乏脊髓空洞症导致肘部关节病的确凿证据的文章。对所选文章的参考文献列表进行审查，以确定其他描述脊髓空洞症所致肘部夏科关节病的文章。本系列中的所有5例患者均患有肘部关节炎，伴有不同程度的运动无力和分离性感觉丧失。文献综述纳入了31篇报告（45例患者）以及来自我们中心的5例患者（n = 50）。就诊时的中位年龄为45（13 - 77）岁。关节病的中位病程为24（0.5 - 180）个月。33例患者为孤立性肘部关节病。其他受累关节包括肩部（n = 13）、腕部（n = 7）、掌指关节（n = 3）和指间关节（n = 1）。33例（66%）患者存在小脑扁桃体下疝畸形。分别有36例（72%）、31例（62%）和14例（28%）患者出现感觉障碍、运动障碍和尺神经病变。13例（26%）患者因脊髓空洞症接受了手术减压。存在分离性感觉丧失，无论有无运动无力，是怀疑脊髓空洞症所致肘部夏科关节病的关键。小脑扁桃体下疝畸形和尺神经病变常与这种情况相关。要点 • 肘部夏科关节病并不像人们认为的那样罕见 • 脊髓空洞症是肘部夏科关节病的一个重要病因 • 因此，所有病因不明的肘部关节病患者都必须评估是否存在分离性感觉丧失 • 小脑扁桃体下疝畸形和尺神经病变常与脊髓空洞症所致肘关节夏科关节病相关。
