[Pain and amyotrophy in upper members in a cirrhotic patient with Pott's disease]. / Dolor y amiotrofia en miembros superiores en una paciente cirrótica afecta del mal de Pott.

We report the case of a 56 year old cirrhotic woman who presented during the course of a tuberculous spondylodiscitis affecting T9-T10, a clinical picture consistent with neuralgic amyotrophy affecting the right shoulder first, and later also the left one (Parsonage-Turner syndrome). This is an uncommonly diagnosed entity of unknown etiology and pathogenesis. Magnetic resonance images (MRI) include high signal intensity in supra and infraspinatus muscles and other muscles of the shoulder girdle, compatible with muscle oedema associated with denervation. These features, combined with the ability of MRI to exclude local problems as tendinitis stresses the importance of this technique in the diagnostic evaluation of patients with neuralgic amyotrophy.

Dolor y amiotrofia en miembros superiores en una paciente cirrótica afecta de mal de Pott / Pain and amyotrophy in upper members in a cirrhotic patient with Pott´s disease

El síndrome de Parsonage-Turner o neuralgia amiotrófica del hombro es una entidad de etiología y patogenia desconocidas. Cursa con dolor intenso localizado en hombro y región proximal del miembro superior, especialmente nocturno, seguido de amiotrofia y debilidad. Se ha descrito en relación con infecciones víricas o bacterianas, procesos inflamatorios o intervenciones quirúrgicas, y suele tener una evolución favorable. Presentamos el caso de una paciente de 56 años de edad, afecta de cirrosis hepática de origen alcohólico, diagnosticada tres meses antes de espóndilodiscitis tuberculosa que afectaba a D9 y D10, que presenta de forma súbita dolor y amiotrofia en hombro y brazo derecho, seguido a las pocas semanas de afectación del lado izquierdo. Un estudio electrofisiológico confirmó el diagnóstico, y se realizó resonancia nuclear magnética, procedimiento diagnóstico útil en estas situaciones, especialmente cuando se planteaba el diagnóstico diferencial con tendinitis por quinolonas

We report the case of a 56-year old cirrhotic woman who presented during the course of a tuberculous spondylodisctis affecting T9-T10, a clinical picture consistent with neuralgic amyotrophy affecting the right shoulder first, and later also the left one (Parsonage-Turner syndrome). This is an uncommonly diagnosed entity of unknown etiology and pathogenesis. Magnetic resonance images (MRI) include high signal intensity in supra and infraspinatus muscles and other muscles of the shoulder girdle, compatible with muscle o edema associated with denervation. These features, combined with the ability of MRI to exclude local problems as tendinitis stresses the importance of this technique in the diagnostic evaluation of patients with neuralgic amyotrophy