二〇二六年四月二十一日

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+title: Radiographic Absence of the Left Humeral Head
+date: 2023-10-25 09:51:54
+tags: Medicine
+---
+
+A 67-year-old man with thoracolumbar scoliosis, poor mobility, and history of frequent falls presented to the emergency department with 2 months of left shoulder pain, stiffness and reduced range of motion, and numbness and paresthesias in his left upper extremity.
+
+Ten years prior to presentation, he underwent surgical decompression for syringomyelia.
+
+A magnetic resonance imaging (MRI) scan of his cervical and thoracic spine performed 2 years prior to presentation revealed a recurrent syrinx extending from Cl C1 to T11, which was not resected because it did not cause symptoms at that time.
+
+On physical examination, he had mild tenderness to palpation and reduced range of motion of the left shoulder with abduction and flexion limited to 120° (normal range of motion, 180°).
+
+The left scapular muscles were atrophic, and pain and temperature sensation were reduced in his proximal left arm, and dorsal aspect of his left shoulder. 
+
+His complete blood cell count, serum glucose levels, C-reactive protein levels, and erythrocyte sedimentation rate were normal.
+
+Results of tests for rheumatoid factor and antinuclear antibody were negative.
+
+Left shoulder radiograph showed complete absence of the left humeral head and a well-demarcated smooth osseous margin of the proximal humerus with associated soft tissue swelling and periarticular calcification.
+
+A chest radiograph taken 2 years prior revealed a normal left shoulder joint. The patient was hospitalized for further evaluation and treatment.
+
+- [报告原档](/papers/Radiographic%20Absence%20of%20the%20Left%20Humeral%20Head.pdf)
+
+这里提到了一种罕见的进展性疾病, 叫Charcot肩, 是一种神经性关节病变，特点是关节迅速被破坏和相关软组织肿胀。患者通常表现为肩部逐渐增大的肿胀，可能伴有疼痛或无痛，肩部无力和活动范围减少。 
+大约80%的Charcot肩患者有脊髓空洞症, 表现为脊髓中的液体充满腔体
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