Two patients with neuropathic arthropathy (NA) of hands and wrists due to cervical syringomyelia are described. Articular deformities resembling rheumatoid arthritis (RA) were present in both cases. RA was misdiagnosed in the first case, leading to incorrect treatment with iatrogenic consequences, and there was real coexistence of RA and NA in the second one. Physicians must be aware of this rare condition in the differential diagnosis of wrist and hand deformities.