Diabetic neuroarthropathy of the shoulder.
Neuroarthropathy of the foot and ankle is a relatively common complication of diabetes mellitus. Likewise, neuroarthropathy of the shoulder has been well reported in relation to syringomyelia. Diabetes mellitus, however, has rarely been reported to cause neuroarthropathy of any joint in the upper extremity and has never previously been reported in the shoulder. This article presents a case of a 77-year-old woman who presented with a secondary complaint of mild right shoulder pain, which had been present since she sustained a proximal humerus fracture four months earlier. The patient's past medical history was notably positive for diabetes mellitus with substantial peripheral neuropathy in the upper and lower extremities. Radiographic examination revealed significant degeneration of the humeral head, consistent with neuroarthropathy of the shoulder. Computed tomography and magnetic resonance imaging demonstrated no syrinx within the spinal cord. The patient's medical history included no etiologies of neuroarthropathy of the shoulder that had been previously reported in the literature. After a thorough literature review, we believe this to be the first case of diabetic shoulder neuroarthropathy to be documented. No significant differences in clinical or radiographic presentations appear to be present between reported etiologies of this pathology, including diabetes mellitus. Consequently, we recommend that diabetes mellitus always be considered as an etiology in the differential diagnosis of neuroarthropathy of the shoulder.
Clayton
Matthew
M
Department of Orthopedic Surgery, Mount Carmel Health System, Columbus, Ohio 43222, USA. mdclaytonmd@gmail.com
Taylor
Benjamin C
BC
Backes
Jeffrey
J
D000368:Aged; D001177:Arthropathy, Neurogenic / Q000175:diagnosis / Q000209:etiology*; D003929:Diabetic Neuropathies / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D012785:Shoulder Joint / Q000294:innervation*; D014057:Tomography, X-Ray Computed