Charcot shoulder

Case contributed by Dr Praveen Jha

Presentation

Right shoulder chronic weakness

Patient Data

Age: 55-60Y
Gender: Male
MRI

MRI of shoulder demonstrates gross bony destruction, and bony defects mimicking Hill-Sach's and Bankart's lesions were noted. In isolation, possibility of recurrent dislocation with septic arthritis was also considered. However, patient did not give any history of shoulder dislocation. Such a massive destruction strongly pointed towards neuropathic joint. And thus, MRI spine was done as additional study to rule out syringomyelia.

MRI

MRI of spine did confirm gross syringomyelia and mild cerebellar tonsillar herniation, may suggest Chiari malformation as antecedent etiology for neuropathic joint.

CT

CT confirms bony debris in distended joint and bursae.

Case Discussion

Marked destruction of bones forming shoulder, with deformed humeral head, marked joint and bursal effusion were seen. Multiple loose bodies/debris seen in distended joint and bursae. Deformed humerus and glenoid does show defects mimicking Hill-Sach's posterolateral humeral defect, and inferior glenoid Bankart's-like lesion. There is also syringomyelia and mild cerebellar tonsillar herniation on spine images.

This case shows classical findings of Charcot Shoulder (Neuropathic joint).

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Case information

rID: 23548
Case created: 23rd Jun 2013
Last edited: 26th Jan 2016
Inclusion in quiz mode: Included

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