OWL: OCOSH Classification/Joint Diseases/Neurogenic Arthropathy

2007 Charcot Arthropathy eMedicine Orthopedics

Shah & Panis — 2008-03-20 00:15:08 GMT

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 significant disruption of the bony architecture. Charcot arthropathy can occur at any joint; however, it occurs most commonly in the lower extremity, at the foot and ankle.
Synonyms and related keywords: Charcot joint, neuropathic osteoarthropathy, diabetic osteoarthropathy, diabetic neuroarthropathy, Charcot foot, Charcot neuroarthropathy, neuropathic arthropathy, neuropathic joint, Schon classification, Brodsky and Rouse system, Saunders and Mrdjencovich system
Shah & Panis 2007

Charcot ankle

Not Available — 2002-01-31 00:15:08 GMT

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.

Charcot joints and neuropathic change

Not Available — 2009-07-22 00:15:08 GMT

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.

Charcot knees

Not Available — 2002-01-31 00:15:08 GMT

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 distal femur by the tibia is consistent with subluxation and the short collateral ligaments.

congenital insensitivity to pain CHORUS

Charles E. Kahn, Jr., M — 2002-01-31 00:15:08 GMT

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

Neuropathic Charcot joint CHORUS

Charles E. Kahn — 2002-01-31 00:15:08 GMT

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

Neuropathic osteoarthropathy

Jones et al — 2009-10-16 00:15:08 GMT

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 fracture are shown. The two prevailing theories for the pathophysiology of neuropathic bone and joint disease, the neurovascular and neurotraumatic theories, are briefly described. Examples of osteoarthropathy from diverse causes are presented including syringomyelia, spinal cord injury, meningomyelocele, diabetes mellitus, congenital insensitivity to pain, steroid injections, syphilis, leprosy, and others. The discussion focuses on key imaging features with emphasis on disease patterns and differential diagnosis, which vary by skeletal location.
Neuropathic osteoarthropathy: diagnostic dilemmas and differential diagnosis. Jones EA, Manaster BJ, May DA, Disler DG. Radiographics. 2000 Oct;20 Spec No:S279-93.

Neuropathic Shoulder Wheeless

C.R.Wheeless — 2002-02-04 00:15:08 GMT

- 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