Abstract

A 42 year old male patient presented with sudden onset painless drooping of right shoulder while lifting himself up with his right arm from squatting position. He was diagnosed to have fracture of spine of righ scapula. Neurological examination of the patient revealed patient’s inability to abduct the right arm and mild weakness of handgrip without associated wasting or fasciculations. Impairment of pain sensation in right half of face, right cervical and upper thoracic dermatomes (T1—T4), and absence of deep tendon reflexes in righ upper limb with brisk deep tendon reflexes in lower limbs were discovered on examination. The patient’s cervico-dorsal Magnetic Resonance Imaging confirmed a syrinx extending from cervico-medullary junction to the upper thoracic segments. The patient did not have any obvious features suggestive of charcot’s arthropathy on clinical and radiological examination. The case highlights the importance of detailed neurological examination and unusual presentation of fracture of spine of scapula in a patient harbouring cervico-dorsal syrinx.

Key words: Syringomyelia; scapula; shoulder fractures; Charcot’s joint; neurogenic arthropathy.