Presentation
Charcot foot. To rule out any secondary osteomyelitis
Patient Data
Subchondral generalized osseous destruction involving mid foot with reduced tarsometatarsal joint space, tarsal marrow edema and exuberant osteophytosis. Mild articular edema. No associated sinus tracks, collections to suggest any secondary infection.
CT correlation reveals the extent of osseous destruction and debris.
Case Discussion
Classic case of Charcot arthropathy with isolated generalized midfoot involvement, subarticular erosions. Important to look for superadded infection. The early stages of osteomyelitis is indistinguishable from the neuroarthropathy. The clinical signs of inflammation should help come to a diagnosis. The more evident findings of an associated sinus track and disproportionately more soft tissue edema / involvement points towards active inflammation.