Chiari malformation with neuropathic shoulder
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Findings
The study reveals Chiari I malformation with pointed peg like cerebellar tonsils lying 12 mm below foramen magnum. Syringohydromyelia seen from C1 to D7-8 levels.
There is destruction and resorption of humeral head with overlying chondral loss and loss of its spherical contour with underlying marrow edema. There is associated anterior dislocation of residual humeral head.
Destruction and resorption is also noted in anteroinferior glenoid with marrow edema.
There is increase acromioclavicular joint space measuring approx. 12 mm.
Significant glenohumeral joint effusion is seen with multiple loose bodies. Fluid is seen extending into subscapularis recess and deep to the pectoralis and deltoid muscle as well as in bursa.
There is full thickness tear of supraspinatus and infraspinatus tendons with severe muscle atrophy (Goutallier grade IV).
Muscle atrophy is also noted in subscapularis and deltoid muscles (Goutallier grade II).
There is atrophy with hyperintensity in muscles of anterior compartment of arm.
Multiple enlarged right axillary and supraclavicular lymphnodes are noted.
There is mass effect over the division cord of right brachial plexus with mild hyperintensity suggesting mild neural edema.
Above findings are suggesting likelihood of neuropathic joint (Charcot joint)
There is destruction and resorption of humeral head with overlying chondral loss and loss of its spherical contour with underlying marrow edema. There is associated anterior dislocation of residual humeral head.
Destruction and resorption is also noted in anteroinferior glenoid with marrow edema.
There is increase acromioclavicular joint space measuring approx. 12 mm.
Significant glenohumeral joint effusion is seen with multiple loose bodies. Fluid is seen extending into subscapularis recess and deep to the pectoralis and deltoid muscle as well as in bursa.
There is full thickness tear of supraspinatus and infraspinatus tendons with severe muscle atrophy (Goutallier grade IV).
Muscle atrophy is also noted in subscapularis and deltoid muscles (Goutallier grade II).
There is atrophy with hyperintensity in muscles of anterior compartment of arm.
Multiple enlarged right axillary and supraclavicular lymphnodes are noted.
There is mass effect over the division cord of right brachial plexus with mild hyperintensity suggesting mild neural edema.
Above findings are suggesting likelihood of neuropathic joint (Charcot joint)
Diagnosis
Chiari 1 malformation with Charcot's joint
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Dr. Utkarsh Kabra MD , EDIR , DICRI is a Consultant Radiologist from with experience of 5-8 years post-graduated from MD(AJ Institute Of Medical Sciences, Mangaluru),EDIR. Specialized in Reporting of X-RAYS , CT-SCAN , MRI cases with expertise in Neuro-imaging , Spine-imaging , Musculoskeletal , Joints , Pediatrics-imaging , Trauma , Stroke-imaging
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