Presentation
40 years old with ongoing bilateral hip pains. Background of congenital insensitivity to pain. Failed right femur fracture fixation.
Patient Data
Significant architectural disorganization of the ankle joints with flattening of the talar dome in keeping with Charcot joint.
Multiple well corticated bone fragments around the ankle mortise and upper calcaneum, sequelae of multiple prior trauma.
Bilateral congenital dysplasia of the hip joints.
Status post right hip Girdlestone osteotomy with pseudoarthrosis between proximal femur and iliac bone.
Left femoral head flattening and subtle serpiginous lucency in keeping with avascular necrosis.
Case Discussion
Congenital insensitivity to pain (CIP) is hereditary condition which leads to inability to feel pain. Patients are prone to multiple self - inflicted traumas with subsequent bone fractures and joints destruction.
Hip dysplasia and avascular necrosis are also commonly seen radiological features of CIP.