Charcot joint

Case contributed by Bruno Di Muzio
Diagnosis certain

Presentation

Inverted ankle 4 weeks ago, now feeling pressure on the lateral aspect.

Patient Data

Age: 50 years
Gender: Male

Ankle and foot radiographs

x-ray

Fragmentation and sclerosis is seen through the mid and hind foot, with collapse of the plantar arch, consistent with a neuropathic joint (Charcot joint). There is subluxation of the talus relative to the tibia, with widening of the medial joint space and significant talar tilt.

No definite acute fracture is identified. Vascular calcifications are noted.

Case Discussion

This is an example of a neuropatic joint in a poorly controlled diabetic patient.

Remember the 6 Ds that characterize the Charcot's joint:

  • increased density (subchondral sclerosis)
  • destruction
  • debris (intra-articular loose bodies)
  • dislocation
  • distention
  • disorganisation

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