Charcots osteoarthropathy

This is an acute osteoarthropathy, with bone and joint destruction, that occurs in the neuropathic foot. Rarely, in diabetes, it can also affect the knee. Patients who develop Charcot's osteoarthropathy usually have evidence of a peripheral neuropathy, autonomic neuropathy and a good blood supply to the lower limb. Patients may have symptoms of autonomic neuropathy such as gastro-paresis, diabetic diarrhoea, gustatory sweating or postural

Fig. 3.14 (a) Spiral fracture of the tibia, (b) Charcot changes at the ankle joint following spiral fracture of the tibia.

hypotension. Diabetic patients with renal transplants have an increased risk of Charcot's osteoarthropathy.

Charcot's osteoarthropathy can be divided into three phases:

• Bony destruction/deformity

• Radiological consolidation and stabilization.

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