We describe a 42-year-old man with right hemiplegia from cerebral palsy who presented with chronic left arm pain. Examination revealed 12 active joints, predominantly in the left hand. Radiographs showed characteristic changes of an advanced secondary osteoarthritic process in the left hand and only minimal changes on the right. Bone scan confirmed unilateral activity. Subsequent investigations diagnosed hemochromatosis. Unilateral arthropathy of hemochromatosis on a neurogenic basis has not been previously reported.