Coraco- or costoclavicular paraosteoarthropathies in patients with severe central neurological disorders.
BACKGROUND
Paraosteoarthropathy (POA) is a frequent disabling orthopedic complication after severe central neurological impairment. The hip is the most frequently affected joint (32.1%) followed by the elbow and the shoulder (25%).


OBJECTIVE
To evaluate coraco- and costoclavicular paraosteoarthropathy in patients with severe central neurological disorders.


METHODS
We report a series of five consecutive patients with severe central neurological disorders who developed a POA of the clavicular region (coracoclavicular or costoclavicular POA). Every patient underwent a clinical, radiological, and computed tomographic (CT) examination of the shoulder region.


RESULTS
Four patients had a history of traumatic brain injury (TBI), and one an acute disseminated encephalomyelitis (ADEM). They developed POA of the clavicular region, although not around the glenohumeral joint. The patients complained of shoulder pain and of moderate limitation of movements. Radiological and CT examinations showed the presence of a bony formation in the coracoclavicular space in four cases and extending from the clavicle to the first rib around the costoclavicular joint in one case.


CONCLUSIONS
In patients with severe brain lesions suffering from shoulder pain and moderate limitation of joint movements, POAs of the clavicular region are rare but should be considered.
Lacout
A
A
Service de Radiologie, Hôpital Raymond Poincaré, Garches, France. lacout.alexis@wanadoo.fr
Mompoint
D
D
Perrier
Y
Y
Vallee
C A
CA
Carlier
R Y
RY
D000328:Adult; D001930:Brain Injuries / Q000150:complications; D002493:Central Nervous System Diseases / Q000150:complications*; D002968:Clavicle / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004673:Encephalomyelitis, Acute Disseminated / Q000150:complications; D005260:Female; D006801:Humans; D007482:Iothalamate Meglumine; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000175:diagnosis / Q000209:etiology; D010003:Osteoarthritis / Q000175:diagnosis* / Q000209:etiology*; D011856:Radiographic Image Enhancement / Q000379:methods; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000000981:diagnostic imaging*; D020069:Shoulder Pain / Q000209:etiology; D036542:Tomography, Spiral Computed / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; C001694:meglumine ioxithalamate; D007482:Iothalamate Meglumine