Teaching NeuroImages: Neuropathic elbow arthropathy due to syringomyelia.

A 45-year-old woman presented with 3 months of left elbow swelling and minimal pain (figure, A). She did not remember any upper extremity injury. On examination, she had arthritis of left elbow, wasting of small muscles of the hand, depressed biceps and supinator jerks, and decreased pain and temperature sensation over C5 to T1 dermatomes bilaterally. Tests for syphilis, diabetes mellitus, and leprosy were negative. Left elbow X-ray revealed joint destruction, disorganization, sclerosis, and debris formation (figure, B), Cervical spine MRI revealed syringomyelia from C2 to T3 vertebra level (figure, C and D). She was diagnosed with neuropathic left elbow arthropathy due to syringomyelia.1,2 AUTHOR CONTRIBUTIONS Aditya Murgai: data acquisition, drafting of manuscript. Pradeep Pankajakshan Nair: drafting and revising of manuscript, concept of the manuscript. Sunil Narayan: drafting and revising of manuscript.