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Charcot arthropathy

Case contributed by Varun Babu
Diagnosis almost certain

Presentation

Charcot foot. To rule out any secondary osteomyelitis

Patient Data

Age: 40 years
Gender: Male
mri

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

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. 

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