Charcot foot

Case contributed by Maxime St-Amant
Diagnosis almost certain


R/o infection.

Patient Data

Age: 85
Gender: Female

Extensive bone remodeling/fragmentation involving the midfoot in this patient with a poorly controlled diabetes, compatible with Charcot's joint (neuropathic arthropathy). 

Case Discussion

This location is highly suggestive of a diabetic etiology; other location are characteristic :

The best imaging clues are included in this mnemonic : 6 Ds 1

  • dense bones (subchondral sclerosis)
  • degeneration 
  • destruction of articular cartilage
  • deformity (pencil-point deformity of metatarsal heads)
  • debris (loose bodies)
  • dislocation

The main differential diagnosis is osteomyelitis and, in some cases, it can evolve as fast.

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