Inverted ankle 4 weeks ago, now feeling pressure on the lateral aspect.
Ankle and foot radiographs
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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.
This is an example of a neuropatic joint in a poorly controlled diabetic patient.
Remember the 6 Ds that characterise the Charcot's joint:
- increased density (subchondral sclerosis)
- debris (intra-articular loose bodies)