Charcot joint in a case of syringomyelia with spinal dysraphism

Abstract

© BMJ Publishing Group Limited 2021. No commercial reuse. See rights and permissions. Published by BMJ. DESCRIPTION A 35yearold man with a swelling over the right shoulder and right anterior chest wall was referred to our hospital. The swelling had been present for over 2 months and was mildly painful. No history of trauma was present. On examination, there was limitation of shoulder movements. Swelling was firm in consistency, nontender, warm on palpation, fixed to underlying muscles and with reduced sensation. There was no significant history of diabetes mellitus. No prior investigation had been done. Shoulder radiograph revealed joint destruction and extensive bone resorption of the head of the right humerus with increased shoulder joint space. Also noted was sclerosis of the proximal right humerus and glenoid cavity. Multiple areas of periarticular soft tissue calcifications were seen around the right shoulder joint with displaced adjacent fat planes (figure 1). CT of the chest was done, which was suggestive of a large, thickwalled peripherally enhancing collection in the region of the right shoulder joint and right anterior and lateral chest wall with multiple osseous fragments/loose bodies within and multiple air foci (figure 2). There was complete resorption of the head and neck of the right humerus, glenoid fossa and lateral aspect of acromion process as well as the coracoid process