Charcot shoulder

Case contributed by Dr Praveen Jha

Presentation

Right shoulder chronic weakness

Patient Data

Age: 55-60Y
Gender: Male
Modality: 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.

Modality: MRI

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

Modality: 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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