Neuropathic arthritis (tabetic joints). (Lexer.)
Locomotor ataxia is a common disease, but syringomyelia has been regarded as exceedingly rare. Nevertheless, Schlesinger has collected 130 cases of it, in one-fourth of which bone and joint symptoms were present. That the nervous system is primarily at fault is made clear, among other things, by the rapidity of involvement occasionally seen, where, for instance, an entire limb becomes edematous, with every indication of severe disturbance. In tabes the lower extremities suffer more often than the others; the reverse is true in cases of syringomyelia. While floating bodies in the joints and ossification of the muscles and soft parts are common in arthritis deformans, they seldom occur in the neuropathic lesions. Suppuration and necrosis are rare in any of these forms, occurring more frequently in the finger than elsewhere, and are probably due to infection of those areas where sensibility is lost and trifling injuries less guarded against. The neuropathic lesions are more commonly symmetrical, and are often accompanied by a cretinic general appearance ([Figs. 196], [197], [198], [199], [200] and [201]).
Fig. 200
Skiagram of joints shown in [Fig. 199]. (Lexer.)
Fig. 201
Arthropathy of syringomyelia. Left elbow, illustrating disintegration, etc., without ulceration or suppuration. (Quenu.)
The joint complications of syringomyelia are frequently characterized by skin lesions which tend to suppurate, by sudden edema, occasionally followed by phlegmon and even necrosis, also by other disturbances of innervation.