Elbow Neuropathic Arthropathy MRI

A middle aged male with unilateral left elbow pain, deformity, progressive swelling, restricted movement.

This MRI elbow joint shows:

Joint effusion, osteolysis involving proximal end of radius as well as ulna, articulating surface of capitulum as well as trochlea. Marked synovial thickening with frond like projections. 

Considering unilateral involvement possibility of infectious aetiology like Tubercular arthritis was one possibility would have been dealt with joint fluid aspiration for culture and sensitivity.

However, MRI CERVICAL SPINE screening was done with suspicion of neuropathic arthropathy which surprisingly revealed cervical cord syrinx.

Here is MRI CERVICAL SPINE of same patient which shows moderate cervical cord syrinx supporting neuropathic arthropathy.

So take home note is it is worthy to suspect and rule out conditions like this whenever applicable and possible as it considerably changes the line of management.