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Vol. 6. Issue 2.
Pages 95-98 (March - April 2010)
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Vol. 6. Issue 2.
Pages 95-98 (March - April 2010)
Case report
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Septic arthritis complicating neuropathic shoulder due to cervical syringomyelia
Artritis séptica como complicación de la artropatía neuropática del hombro asociada a siringomielia cervical
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Norberto Gómez Rodrígueza,
Corresponding author
ngomez@povisa.es

Corresponding author.
, M.a del Carmen de la Puenteb, Jesús Ibáñez Ruána, Marisol González Péreza
a Servicio de Reumatología, Hospital POVISA, Vigo, Spain
b Unidad de Codificación Diagnóstica, Hospital POVISA, Vigo, Spain
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Abstract

One of the main causes of neuropathic osteoarthropathy of the shoulder is cervical syringomyelia. Chronic pain and swelling of the shoulder are the most frequent manifestations, but it occasionally can develop rapid osteoarticular destructive lesions (in less than six weeks), which raise the diagnostic possibility of septic arthritis and some tumours

We present the report of two men with septic arthritis of the shoulder associated with neuropathic arthropathy secondary to syringomyelia. Both patients presented with sudden shoulder pain exacerbated by either passive or active joint movements, malaise and fever. The first patient, a 39-year-old man, suffered left shoulder arthritis due to Staphylococcus aureus. The second patient, a 59-year-old man presented with right shoulder arthritis caused by to Staphylococcus epidermidis. The last microorganism also was isolated in three blood cultures. Infection should certainly be considered as a possible complication of the natural history of the neuropathic shoulder

Keywords:
Septic artritis
Neuropathic arthropathy
Syringomyelia
Staphylococcus aureus
Staphylococcus epidermidis
Resumen

Una de las principales causas de osteoartropatía neuropática del hombro es la siringomielia cervical. El dolor crónico y la tumefacción del hombro son las manifestaciones más frecuentes, pero ocasionalmente pueden desarrollarse lesiones destructivas osteoarticulares de rápida evolución (menos de 6 semanas), que plantean el diagnóstico diferencial con la artritis séptica y algunos tumores.

Describimos 2 varones con artritis séptica sobre artropatía neuropática del hombro secundaria a siringomielia. Ambos cursaron con dolor agudo exacerbado por los movimientos activos y pasivos, malestar general y fiebre. El primero, un hombre de 39 años, presentó una artritis del hombro izquierdo por Staphylococcus aureus. El segundo, un varón de 59 años, sufrió una infección del hombro derecho por Staphylococcus epidermidis, microorganismo que también se aisló en los 3 hemocultivos. El clínico debe considerar la infección como una posible complicación en el curso evolutivo de la artropatía neuropática del hombro.

Palabras clave:
Artritis séptica
Artropatía neuropática
Siringomielia Staphylococcus aureus
Staphylococcus epidermidis
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