Presentation
Foot swelling, reddness and hypothesia of long duration. The patient had long history of diabetes mellitus
Patient Data
There is destruction of the middle and lateral cuneiform bones as well as subluxation and disorganization of talonavicular, naviculo-cuniform, cuboido-cuneiform and intercuneiform joints with associated soft tissue and bone marrow edema. The 2nd to 5th metatarsophalangeal joints show variable degrees of subluxation/dislocation as well.
Diagnosis: neuropathic joint (Charcot joint) due to diabetes mellitus
Case Discussion
Diabetes mellitus can affect the foot by two mechanisms, first one is osteomyelitis and suppurative inflammation and bone destruction which mainly affects the pressure points in forefoot (metatarsal and phalangeal heads) and hindfoot (posterior calcaneus). The 2nd one is neuropathic joint which affects the intertarsal joints leads to joint disorganization, dislocation and destruction.