Multi-joint Charcot arthropathy caused by cervical spondylotic myelopathy and adult degenerative scoliosis with syringomyelia: a case report

Abstract

Background: Charcot arthropathy, also known as neuropathic arthropathy, is a rare disease whose early diagnosis and treatment are very difficult. Generally, diabetes is considered the most common cause of Charcot arthropathy. Although Charcot arthropathy of other secondary etiology has been reported, in most cases only a single joint is accumulated, and rarely involving the feet and shoulders. Clinically, Charcot arthropathy due to delayed diagnosis leads to joint destruction and severe cases abound.

Case presentation: What we report is an unprecedented case, in which the patient was diagnosed as left shoulder joint, interdigital joint Charcot arthropathy caused by cervical spondylotic myelopathy (CSM) and left knee and right ankle Charcot arthropathy caused by adult degenerative scoliosis (ADS) complicated by syringomyelia. The 82-year-old male patient was admitted to the hospital for complaining of pain in the left knee joint. Except for scoliosis that was discovered 10 years ago, the patient denied any other obvious past medical history. Clinical/surgical manifestations, detailed physical examinations and auxiliary examinations all indicated the presence of polyarticular Charcot arthropathy, but common causes of Charcot arthropathy such as diabetes and syphilis have not been detected. After making a comprehensive differential diagnosis, we finally made the above diagnosis.

Conclusions: This previously unreported case describes the complexity and etiological diversity of Charcot arthropathy. We recommend that patients with CSM and/or scoliosis, spinal deformity undergo further examination and regular follow-up. A detailed medical history and careful physical examination are necessary for the correct diagnosis of Charcot arthropathy. Although the early diagnosis of Charcot arthropathy cannot change the natural course of the disease, it is beneficial to alleviate symptoms and prevent serious complications.

Keywords: Charcot arthropathy; adult degenerative scoliosis; cervical spondylotic myelopathy; syringomyelia.