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Thoracic Spinal Arachnoid Cyst Causing Neuropathic Arthropathy of the Elbow

Received: 19 August 2022    Accepted: 13 September 2022    Published: 27 September 2022
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Abstract

Neuropathic arthropathy (NA), or Charcot arthropathy, involves rapid degeneration and instability of a joint caused by hypesthesia. This condition is commonly caused by diabetes, while syringomyelia and arachnoid granulations are rare causes of NA. We report a 50-year old male who presents with progressive numbness to his arms, weakness to his right hand and mass to the right elbow. A diagnosis of neuropathic arthropathy of the elbow was made after MRI of the cervical and thoracic spine revealed a compressive thoracic arachnoid granulation causing cervical syringomyelia. We highlight the importance of a thorough workup including key imaging characteristics that resulted in the diagnosis. Thoracic surgical decompression successfully restored CSF flow and reduced the cervical syringomyelia. The patient remained neurologically stable at the most recent follow-up, although no known treatment halts disease progression once NA has developed.

Published in International Journal of Neurosurgery (Volume 6, Issue 2)
DOI 10.11648/j.ijn.20220602.14
Page(s) 48-51
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Neuropathic Arthropathy, Charcot Joint, Arachnoid Cyst, Syringomyelia

References
[1] Snoddy MC, Lee DH, Kuhn JE. Charcot shoulder and elbow: a review of the literature and update on treatment. J Shoulder Elbow Surg. 2017 Mar; 26 (3): 544-552. doi: 10.1016/j.jse.2016.10.015. Epub 2017 Jan 19. PMID: 28111181.
[2] Buse AM, Mihai DA, Lupu L, Salmen T, Stegaru D, Radulian G. The Charcot Neuroarthropathy as Onset of Type 2 Diabetes - a Diagnostic Challenge. Maedica (Bucur). 2020 Mar; 15 (1): 122-125. doi: 10.26574/maedica.2020.15.1.122. PMID: 32419872; PMCID: PMC7221283.
[3] Parida MK, Pattanaik SS, Panda AK, Das BK, Tripathy SR. Charcot arthropathy of elbow due to syringomyelia: a case series and systematic review of literature. Clin Rheumatol. 2022 Aug 22. doi: 10.1007/s10067-022-06332-7. Epub ahead of print. PMID: 35994178.
[4] Flint G. Syringomyelia: diagnosis and management. Pract Neurol. 2021 Oct; 21 (5): 403-411. doi: 10.1136/practneurol-2021-002994. Epub 2021 Aug 25. PMID: 34433683.
[5] Mallucci CL, Stacey RJ, Miles JB, Williams B. Idiopathic syringomyelia and the importance of occult arachnoid webs, pouches and cysts. Br J Neurosurg. 1997 Aug; 11 (4): 306-9. doi: 10.1080/02688699746087. PMID: 9337928.
[6] Jones EA, Manaster BJ, May DA, Disler DG. Neuropathic osteoarthropathy: diagnostic dilemmas and differential diagnosis. Radiographics. 2000 Oct; 20 Spec No: S279-93. doi: 10.1148/radiographics.20.suppl_1.g00oc22s279. PMID: 11046179.
[7] Waldman S, Shimonov M, Yang N, Spielman D, Godfrey KJ, Dean KE, Phillips CD, Helman SN. Benign bony tumors of the paranasal sinuses, orbit, and skull base. Am J Otolaryngol. 2022 May-Jun; 43 (3): 103404. doi: 10.1016/j.amjoto.2022.103404. Epub 2022 Feb 26. PMID: 35246319.
[8] Dogan BE, Sahin G, Yagmurlu B, Erden I. Neuroarthropathy of the extremities: magnetic resonance imaging features. Curr Probl Diagn Radiol. 2003 Nov-Dec; 32 (6): 227-32. doi: 10.1016/j.cpradiol.2003.08.004. PMID: 14647121.
[9] Wawrzyniak A, Lubiatowski P, Kordasiewicz B, Brzóska R, Laprus H. Shoulder arthropathy secondary to syringomyelia: case series of 10 patients. Eur J Orthop Surg Traumatol. 2022 Oct; 32 (7): 1275-1281. doi: 10.1007/s00590-021-03102-0. Epub 2021 Aug 24. PMID: 34430987.
[10] Rastogi A, Bhansali A, Jude EB. Efficacy of medical treatment for Charcot neuroarthropathy: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetol. 2021 Jun; 58 (6): 687-696. doi: 10.1007/s00592-020-01664-9. Epub 2021 Jan 13. PMID: 33439331.
Cite This Article
  • APA Style

    Adam Alayli, Jonah Gordon, Khaled Abdelghany, Gavin Lockard, Anthony Urbisci, et al. (2022). Thoracic Spinal Arachnoid Cyst Causing Neuropathic Arthropathy of the Elbow. International Journal of Neurosurgery, 6(2), 48-51. https://doi.org/10.11648/j.ijn.20220602.14

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    ACS Style

    Adam Alayli; Jonah Gordon; Khaled Abdelghany; Gavin Lockard; Anthony Urbisci, et al. Thoracic Spinal Arachnoid Cyst Causing Neuropathic Arthropathy of the Elbow. Int. J. Neurosurg. 2022, 6(2), 48-51. doi: 10.11648/j.ijn.20220602.14

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    AMA Style

    Adam Alayli, Jonah Gordon, Khaled Abdelghany, Gavin Lockard, Anthony Urbisci, et al. Thoracic Spinal Arachnoid Cyst Causing Neuropathic Arthropathy of the Elbow. Int J Neurosurg. 2022;6(2):48-51. doi: 10.11648/j.ijn.20220602.14

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  • @article{10.11648/j.ijn.20220602.14,
      author = {Adam Alayli and Jonah Gordon and Khaled Abdelghany and Gavin Lockard and Anthony Urbisci and Gautam Rao and Nam Tran},
      title = {Thoracic Spinal Arachnoid Cyst Causing Neuropathic Arthropathy of the Elbow},
      journal = {International Journal of Neurosurgery},
      volume = {6},
      number = {2},
      pages = {48-51},
      doi = {10.11648/j.ijn.20220602.14},
      url = {https://doi.org/10.11648/j.ijn.20220602.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.14},
      abstract = {Neuropathic arthropathy (NA), or Charcot arthropathy, involves rapid degeneration and instability of a joint caused by hypesthesia. This condition is commonly caused by diabetes, while syringomyelia and arachnoid granulations are rare causes of NA. We report a 50-year old male who presents with progressive numbness to his arms, weakness to his right hand and mass to the right elbow. A diagnosis of neuropathic arthropathy of the elbow was made after MRI of the cervical and thoracic spine revealed a compressive thoracic arachnoid granulation causing cervical syringomyelia. We highlight the importance of a thorough workup including key imaging characteristics that resulted in the diagnosis. Thoracic surgical decompression successfully restored CSF flow and reduced the cervical syringomyelia. The patient remained neurologically stable at the most recent follow-up, although no known treatment halts disease progression once NA has developed.},
     year = {2022}
    }
    

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    T1  - Thoracic Spinal Arachnoid Cyst Causing Neuropathic Arthropathy of the Elbow
    AU  - Adam Alayli
    AU  - Jonah Gordon
    AU  - Khaled Abdelghany
    AU  - Gavin Lockard
    AU  - Anthony Urbisci
    AU  - Gautam Rao
    AU  - Nam Tran
    Y1  - 2022/09/27
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijn.20220602.14
    DO  - 10.11648/j.ijn.20220602.14
    T2  - International Journal of Neurosurgery
    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
    SP  - 48
    EP  - 51
    PB  - Science Publishing Group
    SN  - 2640-1959
    UR  - https://doi.org/10.11648/j.ijn.20220602.14
    AB  - Neuropathic arthropathy (NA), or Charcot arthropathy, involves rapid degeneration and instability of a joint caused by hypesthesia. This condition is commonly caused by diabetes, while syringomyelia and arachnoid granulations are rare causes of NA. We report a 50-year old male who presents with progressive numbness to his arms, weakness to his right hand and mass to the right elbow. A diagnosis of neuropathic arthropathy of the elbow was made after MRI of the cervical and thoracic spine revealed a compressive thoracic arachnoid granulation causing cervical syringomyelia. We highlight the importance of a thorough workup including key imaging characteristics that resulted in the diagnosis. Thoracic surgical decompression successfully restored CSF flow and reduced the cervical syringomyelia. The patient remained neurologically stable at the most recent follow-up, although no known treatment halts disease progression once NA has developed.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • College of Medicine, University of South Florida Morsani, Tampa, Unites States

  • College of Medicine, University of South Florida Morsani, Tampa, Unites States

  • College of Medicine, University of South Florida Morsani, Tampa, Unites States

  • College of Medicine, University of South Florida Morsani, Tampa, Unites States

  • Department of Physical Medicine and Rehabilitation, James A. Haley Veterans Hospital, University of Florida, Tampa, Unites States

  • Department of Neurosurgery, University of South Florida, Tampa, Unites States

  • Department of Neurosurgery, University of South Florida, Tampa, Unites States

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