- Usually secondary to syringomyelia – 75%
- Difficulty is in diagnosis
History
- decreased sensation in both hands
- difficulties with clumsy hands, balance, gait
- bowel/bladder problems
Exam
- long tract signs
- detailed neurologic exam
- vibration sense
- 2 point discrimination
Xrays
- flattening of humeral head with fragmentation, subluxation & periarticular bone debris
Treatment
- Nonoperative
- rest, NSAIDs, activity modification
- Operative
- seldom indicated
- high rate of failure