Introduction: Neuropathic arthropathy is seen in 25% of all cases with syringomyelia, and 80% of those occur in the upper extremity. Shoulder joint involvement has been reported in 6% of patients with neuropathic arthropathy.
Case presentation: 45 y old female presented to OPD with pain over nape of neck radiating to right shoulder. Clinically the movements of right arm were restricted. The patient was investigated in the form of cervical spine and shoulder X-ray. Shoulder X-ray showed destroyed joint. Cervical spine X-ray showed pathology at C4, C5 and C6 levels. Meticulous history and examination suggested spinal involvement and trauma previously. MRI was done. The patient was treated conservatively. Patient now has got full range of movements of the arm.
Conclusion: Neuropathic arthropathy of the shoulder is rare, and if not evaluated carefully can be misdiagnosed. Considering only the involving joint, tumor is the most common diagnosis if proper neurological and physical examination is not done.