Red, hot, swollen left foot. Minor Pain – No trauma. Poorly controlled type 2 diabetes.
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AP and lateral plain foot radiographs in a diabetic patient with chronic neuropathic arthropathy. Destruction of the tarsometatarsal (Lisfranc) joint. Periosteal reaction and new bone formation at the 1st metatarsal which remains congruent (No subluxation).Surrounding soft tissue swelling is present.
Loose bodies on the lateral view.
All these features are consistent with Charcot foot.
Mnemonic - 6 Ds of charcot joint
- dense bones (subchondral sclerosis)
- destruction of articular cartilage
- deformity (pencil-point deformity of metatarsal heads)
- debris (loose bodies)
- 1. Mautone M, Naidoo P. What the radiologist needs to know about Charcot foot. J Med Imaging Radiat Oncol. 2015;59 (4): 395-402. doi:10.1111/1754-9485.12325