6.8.2013(charcot Joint) Flashcards
Risk of amputation in Charcot arthropathy and diabetic ulcers
More in diabetic foot ulcer
Most common cause of Charcot joint
Diabetes mellitus
Common sites of Charcot arthropathy
Foot and ankle
Causes of Charcot joint
Diabetes Syphilis Meningomyelocele Syringomyelia Chronic alcoholism Leprosy Congenital insensitivity to pain Renal dialysis Charcot Marie tooth disease Amyloidosis
Pathophysiology of Charcot joint
Neurotraumatic
Neurovascular
Passive movement of Charcot jt feels as
Loose bag of bones
Diff btw osteomyelitis and Charcot joint
Intact skin
Loss of sensation
Bone scan is positive osteomyelitis
Complications of Charcot arthropathy
Club foot
Rocker bottom foot
Osteomyelitis
Amputation
Different sites of Charcot joint and their causes
Tarsal,Ankle- DM
large jts of lower limb-leprosy,tabes
Shoulder jt- syringomyelia
X ray in Charcot jt
Subluxation
Joint destruction
Irregular calcified masses
Charcot jt in diabetic foot most commonly affects
Mid tarsal jt
Presentation of Charcot joint
Painless swelling Erythematous Warm Edematous Intact skin Loss of sensation
Common deformity in diabetic Charcot
Rocker bottom feet
MRI of Charcot disease
Low signal intensity in marrow in both T1 and T2 disease
High T2 intensity in osteomyelitis
Stages of Charcot disease
Active: joint effusion,intraarticular fracture,fragmentation and joint subluxation
Coalescent stage: fracture healing
Reconstructive: remodelling and bony ankylosis
Charcot jt due syringomyelia affects which joints
Shoulder
Elbow
Wrist
Jts affected in tabes
Hip
Knee
Elbow
Jts affected in DM
Tarsal
Taro metatarsal jt
Pathological features of Charcot arthropathy is similar to
Severe osteoarthritis
Joint pain in Charcot
Less compared to degree of joint damage
Sudden pain may be due to intraarticular fractures of osteophytes or condyles
Destructive changes at tarsometatarsal joints in diabetic foot
Lisfranc fracture dislocation
Role of bone scans in differentiating Charcot and osteomyelitis
Indium 111 labelled WBC or indium 111 labelled IgG scans show increased uptake only in osteomyelitis
Technitium scan is not useful as increased uptake is seen in both
In Charcot joint weight bearing should be avoided for how many weeks to allow proper rehabilitation
8 weeks
