NEUROPATHIC ARTHROPATHY OF THE HAND ASSOCIATED WITH CERVICAL SYRINGOMYELIA

Neuropathic osteoarthropathy is a rare chronic, degenerative arthropathy associated with decreased sensory innervation. Numerous causes of this arthropathy have been described, syringomyelia, fluid-filled intramedular cavity, being among them. Neuropathic osteoarthropathy associated with syringomyelia is usually mono/oligo-articular, asymmetrical, involving the elbow, shoulder, rarely the wrist. Skin and nails trophic changes sometimes may appear. The present case is that of a female patient with asymmetrical oligoarthritis of right wrist and metacapophalangean joints with rapid reumathoid-like deformity of the hand. The diagnosis key was the radiologic aspect with both lytic and sclerotic lesions but also the thermal sensory impairment, minimized by the patient, longtime considered to be related to cervival spine osteoarthritis. The MRI examination of the cervical spine confirmed the fluid-filled cavity of the whole cervival region with secondary medular atrophy.