Neurogenic Arthropathy (Subscribe)  

Radiology case 468-821 Clinical presentation: Middle aged insulin dependent diabetic with right ankle swelling and deformity. There is marked soft tissue swelling with fragmentation of the bones, joint destruction, but no reduction in bone density.

Also called Charcot joint or neuropathic joint, Charcot arthropathy is a progressive condition of the musculoskeletal system that is characterized by joint dislocations, pathologic fractures, and debilitating deformities. This disorder results in progressive destruction of bone and soft tissues at weight-bearing joints; in its most severe form, it may cause...

Classically the Charcot joint comprises extremely dense bones with sclerotic joint margins which are grossly distorted.
In the lower limbs the causes for neuropathic change might be diabetes, inherited neuropathy, Vit B12 deficiency, neurosyphilis and leprosy. In the upper limbs one would add the associated sensory neuropathy that is found in syringomyelia.

Radiology case 458-821 Clinical presentation: Eccentric old man with high stepping gait and painless swelling of his knee. There is deformity of the bone ends with marked osteosclerosis and bone loss. Fragmentation and extension of the articular surfaces indicates subluxation and continued movement. There is no regional osteoporosis. The hollowing of the...

# autosomal recessive
# neuropathic joints
# micro- and macrofractures
# epiphyseal separation
# osteomyelitis (mandible, fingers, toes)

neuropathic (Charcot) joint
6 D's
* destruction
* increased density
* dislocation
* debris
* distension
* disorganization

The purpose of this pictorial essay is to illustrate the radiologic spectrum of imaging findings of neuropathic osteoarthropathy. Typical findings include joint destruction, disorganization, and effusion with osseous debris. A variety of other imaging findings related to neuropathic osteoarthropathy such as resorption of the ends of tubular bones and neuropathic...

- neuropathic shoulder may result from syringomyelia (most common), chiari malformation, or syphilis;
- in some cases, it may be confused w/ shoulder instability;
Wheeless' Textbook of Orthopaedics