eMedicine Specialties > Radiology > Musculoskeletal

Neuropathic Arthropathy (Charcot Joint): Follow-up

Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist, North Manchester General Hospital, The Pennine Acute NHS Trust, Manchester UK
Coauthor(s): Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK; Ian Turnbull, MB, ChB, MD, DMRD, FRCR, Lecturer, Department of Radiology, University of Manchester; Consulting Neuroradiologist, Hope Hospital, Salford, Manchester and North Manchester General Hospital, UK; Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Contributor Information and Disclosures

Updated: May 27, 2008

Intervention

Medicolegal Pitfalls

  • The incidence of osteomyelitis is increased in patients with neuropathic joints, particularly in the foot. Hence, careful follow-up imaging is essential.
 


More on Neuropathic Arthropathy (Charcot Joint)

Overview: Neuropathic Arthropathy (Charcot Joint)
Imaging: Neuropathic Arthropathy (Charcot Joint)
Follow-up: Neuropathic Arthropathy (Charcot Joint)
Multimedia: Neuropathic Arthropathy (Charcot Joint)
References

References

  1. Bar-On E, Floman Y, Sagiv S, et al. Orthopaedic manifestations of familial dysautonomia. A review of one hundred and thirty-six patients. J Bone Joint Surg Am. Nov 2000;82-A(11):1563-70. [Medline].

  2. Bloomgarden ZT. American Diabetes Association 60th Scientific Sessions, 2000: the diabetic foot. Diabetes Care. May 2001;24(5):946-51. [Medline].

  3. Deirmengian CA, Lee SG, Jupiter JB. Neuropathic arthropathy of the elbow. A report of five cases. J Bone Joint Surg Am. Jun 2001;83-A(6):839-44. [Medline].

  4. Jones EA, Manaster BJ, May DA, Disler DG. Neuropathic osteoarthropathy: diagnostic dilemmas and differential diagnosis. Radiographics. Oct 2000;20 Spec No:S279-93. [Medline].

  5. Kapila A, Lines M. Neuropathic spinal arthropathy: CT and MR findings. J Comput Assist Tomogr. Jul-Aug 1987;11(4):736-9. [Medline].

  6. Sommer TC, Lee TH. Charcot foot: the diagnostic dilemma. Am Fam Physician. Nov 1 2001;64(9):1591-8. [Medline].

  7. Sanders LJ. What lessons can history teach us about the Charcot foot?. Clin Podiatr Med Surg. Jan 2008;25(1):1-15. [Medline].

  8. Koop I, Loreck D, Krause A. Diabetic neuropathic arthropathy. Arthritis Rheum. Apr 1999;42(4):806. [Medline].

  9. Rostom S, Bahiri R, Mahfoud-Filali S, Hajjaj-Hassouni N. Neurogenic osteoarthropathy in leprosy. Clin Rheumatol. Dec 2007;26(12):2153-5. [Medline].

  10. Soysal N, Ayhan M, Guney E, Akyol A. Differential diagnosis of Charcot arthropathy and osteomyelitis. Neuro Endocrinol Lett. Oct 2007;28(5):556-9. [Medline].

  11. Devendra D, Farmer K, Bruce G, et al. Diagnosing osteomyelitis in patients with diabetic neuropathic osteoarthropathy. Diabetes Care. Dec 2001;24(12):2154-5. [Medline].

  12. Wagner SC, Schweitzer ME, Morrison WB, et al. Can imaging findings help differentiate spinal neuropathic arthropathy from disk space infection? Initial experience. Radiology. Mar 2000;214(3):693-9. [Medline].

  13. Palestro CJ, Mehta HH, Patel M, et al. Marrow versus infection in the Charcot joint: indium-111 leukocyte and technetium-99m sulfur colloid scintigraphy. J Nucl Med. Feb 1998;39(2):346-50. [Medline].

  14. Alnafisi N, Yun M, Alavi A. F-18 FDG positron emission tomography to differentiate diabetic osteoarthropathy from septic arthritis. Clin Nucl Med. Jul 2001;26(7):638-9. [Medline].

  15. Basu S, Chryssikos T, Houseni M, Scot Malay D, Shah J, Zhuang H, et al. Potential role of FDG PET in the setting of diabetic neuro-osteoarthropathy: can it differentiate uncomplicated Charcot's neuroarthropathy from osteomyelitis and soft-tissue infection?. Nucl Med Commun. Jun 2007;28(6):465-72. [Medline].

  16. Judge MS. Infection and neuroarthropathy: the utility of C-reactive protein as a screening tool in the Charcot foot. J Am Podiatr Med Assoc. Jan-Feb 2008;98(1):1-6. [Medline].

  17. Naqvi A, Cuchacovich R, Saketkoo L, Espinoza LR. Acute Charcot arthropathy successfully treated with pamidronate: long-term follow-up. Am J Med Sci. Feb 2008;335(2):145-8. [Medline].

  18. Noonan KJ, Didelot WP, Lindseth RE. Care of the pediatric foot in myelodysplasia. Foot Ankle Clin. Jun 2000;5(2):281-304, vi. [Medline].

  19. Pitocco D, Collina MC, Musella T, Ruotolo V, Caputo S, Manto A, et al. Interaction between IGF-1, inflammation, and neuropathy in the pathogenesis of acute charcot neuroarthropathy: lessons from alendronate therapy and future perspectives of medical therapy. Horm Metab Res. Mar 2008;40(3):163-4. [Medline].

  20. Sliwa JA, Rippe D, Do V. Charcot spine in a person with congenital insensitivity to pain with anhydrosis: a case report of re-diagnosis. Arch Phys Med Rehabil. Mar 2008;89(3):568-71. [Medline].

  21. Sutterfield R. Light therapy and advanced wound care for a neuropathic plantar ulcer on a Charcot foot. J Wound Ostomy Continence Nurs. Jan-Feb 2008;35(1):113-5; discussion 116-7. [Medline].

Further Reading

Keywords

neurotrophic joint, neuropathic joint disease, neuroarthropathy, Charcot joint disease, arthropathy, neuropathic osteoarthropathy, destruction of articular surfaces, dense subchondral bones, joint debris, joint deformity, dislocation, hypertrophic neuropathic osteoarthropathy, atrophic neuropathic osteoarthropathy, disorganized joints

Contributor Information and Disclosures

Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, Consultant Radiologist, North Manchester General Hospital, The Pennine Acute NHS Trust, Manchester UK
Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR is a member of the following medical societies: American Association for the Advancement of Science, American Institute of Ultrasound in Medicine, British Medical Association, British Society of Interventional Radiology, Royal College of Physicians, Royal College of Physicians and Surgeons of the United States, Royal College of Radiologists, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Coauthor(s)

Muthusamy Chandramohan, MBBS, DMRD, FRCR, Consultant Radiologist, Bradford Teaching Hospitals, UK
Disclosure: Nothing to disclose.

Ian Turnbull, MB, ChB, MD, DMRD, FRCR, Lecturer, Department of Radiology, University of Manchester; Consulting Neuroradiologist, Hope Hospital, Salford, Manchester and North Manchester General Hospital, UK
Disclosure: Nothing to disclose.

Sumaira MacDonald, MBChB, PhD, MRCP, FRCR, Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield Vascular Institute
Sumaira MacDonald, MBChB, PhD, MRCP, FRCR is a member of the following medical societies: British Medical Association, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

Amilcare Gentili, MD, Clinical Professor of Radiology, University of California at San Diego; Consulting Staff, Department of Radiology, Thornton Hospital
Amilcare Gentili, MD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Wilfred CG Peh, MD, MBBS, FRCP(Glasg), FRCP(Edin), FRCR, Clinical Professor, Faculty of Medicine, National University of Singapore; Senior Consultant Radiologist, Alexandra Hospital, Singapore
Wilfred CG Peh, MD, MBBS, FRCP(Glasg), FRCP(Edin), FRCR is a member of the following medical societies: American Roentgen Ray Society, British Institute of Radiology, International Skeletal Society, Radiological Society of North America, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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