Rapidly progressive neuropathic arthropathy of the knee in possible association with a huge extruded cervical intervertebral disc herniation.
A 58-year-old woman with an insignificant stage of diabetes mellitus presented with rapidly progressive osteoarthritis of her right knee exhibiting painless but significant antero-posterior and lateral instability. In association, she had a huge extruded left-sided cervical intervertebral disc at the C4-5 level. Neurological examination of the upper limbs was normal but, she had diminished pinprick sensation on the right leg. Radiographic findings were consistent with neuropathic arthropathy of the knee. Anterior decompression with fusion of C4-5 and total knee arthroplasty using a semi-constrained-type artificial implant were performed in one stage. The patient regained nearly normal living activity following surgical intervention. We stress the possibility of rapid progression of knee joint arthropathy, as neuropathic knee, even in a patient with less significant symptoms and signs of cervical myelopathy caused by a huge extruded intervertebral disc.
Nakajima
Hideaki
H
Department of Orthopaedics and Rehabilitation Medicine, University of Fukui Faculty of Medical Sciences, Shimoaizuki 23, Eiheiji Matsuoka, Fukui, 910-1193, Japan. nhideaki@u-fukui.ac.jp
Uchida
Kenzo
K
Oki
Hisashi
H
Yayama
Takafumi
T
Mwaka
Erisa
E
Kokubo
Yasuo
Y
Sato
Ryuichiro
R
Kobayashi
Shigeru
S
Orwotho
Norbert
N
Baba
Hisatoshi
H
D000203:Activities of Daily Living; D000208:Acute Disease; D001177:Arthropathy, Neurogenic / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D001178:Arthroplasty; D002574:Cervical Vertebrae / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D019299:Decompression, Surgical; D018450:Disease Progression; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000473:pathology / Q000601:surgery; D007593:Joint Instability / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000294:innervation / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures; D019919:Prosthesis Implantation / Q000379:methods; D020886:Somatosensory Disorders / Q000150:complications / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000150:complications* / Q000473:pathology / Q000601:surgery; D055009:Spondylosis / Q000150:complications / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome