Bone Health

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 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

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.

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