title: Syringomyelia with Chiari I malformation presenting as hip charcot arthropathy: a case report and literature review.
abstract: Neuroarthropathy (neuropathic osteoarthropathy), also known as Charcot joint, is a condition characterized by a progressive articular surface destruction in the setting of impaired nociceptive and proprioceptive innervation of the involved joint. It is seen most commonly in the foot and ankle secondary to peripheral neuropathy associated with diabetes mellitus. Cases of hip (Charcot) neuroarthropathy are rare and almost exclusively reported in patients with neurosyphilis (tabes dorsalis). We report a case of a 36-year-old man who presented to the emergency department complaining of right hip pain. On physical examination, pain and thermal sensory deficits were noted in the upper torso with a cape-like distribution, as well as signs of an upper motor neuron lesion in the left upper and lower extremities. A magnetic resonance imaging study (MRI) of the right hip showed evidence of early articular surface destruction and periarticular edema consistent with hip Charcot arthropathy. An MRI of the spine revealed an Arnold-Chiari type I malformation with extensive syringohydromyelia of the cervical and thoracic spine.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.
authors.forename: Roya
authors.initials: R
authors.lastname: Memarpour
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.
authors.forename: Basheer
authors.identifier: 0000-0001-8816-3725
authors.initials: B
authors.lastname: Tashtoush
authors.affiliation: Ross University School of Medicine, 630 US Highway 1, North Brunswick, NJ 08902, USA.
authors.forename: Lydia
authors.identifier: 0000-0001-9584-1272
authors.initials: L
authors.lastname: Issac
authors.affiliation: Department of Internal Medicine, Mount Sinai School of Medicine, Jersey City Medical Center, 355 Grand Street, Jersey City, NJ 07302, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gonzalez-Ibarra