SHOULDER ARTHROPATHY SECONDARY TO SYRINGOMYELIA – NEW X-RAY CLASSIFICATION OF SHOULDER DEGENERATION

Abstract

Introduction Shoulder neuroarthropathy is a rare joint degeneration mostly related to syringomyelia. An X-ray is a basic tool to stage the advancement of shoulder destruction in shoulder neuroarthropathy. Aim We aimed to create and verify the reliability of our own radiographic classification of shoulder degeneration (NGH) and to correlate it with clinical features. Material and methods The study included 39 cases (45 shoulders with neuroarthropathy secondary to syringomyelia) collected from a systematic literature review and our own pooled series of 10 cases. We found 34 papers, all being case reports or case series. Inclusion criteria were an X-ray in two projections and the availability of clinical data. Our NGH classification was as follows: for glenoid (G) and head (H), three stages were distinguished: G0/H0, no X-ray changes; G1/H1, partial degeneration; and G2/H2, total degeneration. Results The statistical analysis showed almost perfect agreement between the evaluators for the humeral head and glenoid in both measurements and almost perfect compatibility. The majority of patients had total head degeneration without correlation with a range of motion. The glenoid condition was various and had no statistical influence on shoulder function. Both the G and H stages had an impact on the incidence of swelling and weakness. Conclusions These findings indicate that our NGH classification is highly reliable for staging shoulder degeneration related to syringomyelia. The classification seemed to correlate with the clinical condition partly. Under this system, patients with stages G0 and G1 can still qualify for reverse shoulder arthroplasty.