Charcot neuroarthropathy
(redirected from Charcot joint disease)Charcot neuroarthropathy
; Charcot joint disease; neuropathic osteoarthropathy gross distortion of weight-bearing joints secondary to long-term sensory and autonomic neuropathy, abnormal inflammatory and healing responses; early immobilization for a minimum of 12 weeks is essential to minimize joint distortion; typical of diabetes mellitus and tabes dorsalis (syphilis)atrophic Charcot neuroarthopathy; diabetic osteolysis joint destruction characterized by rapid hyperaemic bone resorption (secondary to autonomic neuropathy, abnormal bone blood flow and local periarticular osteopenia) leading to 'pencilling' ('sucked candy stick') of distal metatarsals
hypertrophic Charcot neuroarthropathy joint destruction characterized by rapid loss of joint architecture (secondary to pain and proprioception loss and local cortical microfractures) and associated disorganized osseous proliferation (due to abnormal bone-healing response) with resultant foot deformity, often of midtarsal or ankle joints (Table 1and Table 2)
Stage | Characteristics |
0 | Clinical symptoms only: erythema, oedema, increased temperature (>2°c difference) |
I | Developmental: generalized bone demineralization, periarticular fragmentation, loose-body formation, joint dislocation |
II | Coalescent: organization and healing of fracture fragments, periosteal new bone formation, resorption of bone debris |
III | Reconstruction/consolidation: greater definition of bone contours, reconstruction or ankylosis of involved bone |
Vascular | Neuropathic | Skeletal | Cutaneous sequelae |
Bounding pulses Erythema Oedema Warmth | Lost or reduced: Pain/vibration awareness Proprioception Deep tendon reflexes | 'Rocker bottom' foot Midfoot subluxation Digital contracture Hypermobility | Hyperkeratosis Trophic ulceration Secondary infection |