Neuropathic Arthropathy (Charcot Joint) ... and EDS ... ankle pain

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Neuropathic Arthropathy (Charcot Joint)

Last Updated: February 28, 2003 Rate this Article

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Synonyms and related 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

AUTHOR INFORMATION Section 1 of 11

Author Information Introduction Differentials X-ray Cat Scan MRI Ultrasound

Nuclear Medicine Intervention Pictures Bibliography

Author: Ali Nawaz Khan, MBBS, FRCP, FRCR, Lecturer, Department of Diagnostic

Radiology, Faculty of Medicine, University of ManchesterCoauthor(s): Muthusamy

Chandramohan, MBBS, DMRD, FRCR, Special Registrar, Department of Radiology,

Manchester Radiology; Ian Turnbull, MD, Lecturer, Department of Radiology,

University of Manchester; Consulting Neuroradiologist, Hope Hospital, Salford,

Manchester and North Manchester Hospital; Sumaira Macdonald, MBChB, MRCP, FRCR,

Lecturer, Sheffield University Medical School; Endovascular Fellow, Sheffield

Vascular Institute

Ali Nawaz Khan, MBBS, FRCP, FRCR, is a member of the following medical

societies: American Institute of Ultrasound in Medicine, British Institute of

Radiology, British Medical Association, Radiological Society of North America,

Royal

College of Physicians, Royal College of Radiologists, and Royal College of

Surgeons of England

Editor(s): Amilcare Gentili, MD, Consulting Staff, Clinical Professor of

Radiology, Department of Radiology, University of California at San Diego

-Thornton Hospital; Bernard D Coombs, MBChB, PhD, Consulting Staff, Department

of

Specialist Rehabilitation Services, Hutt Valley District Health Board, New

Zealand; Wilfred CG Peh, MBBS, MD, FRCPE, FRCPG, FRCR, Clinical Professor,

Faculty of

Medicine, National University of Singapore; Senior Consultant Radiologist,

Programme Office, Singapore Health Services; M Krasny, MD, Visiting

Assistant Professor of Radiology, University of California at Los Angeles

Medical

Center; Consulting Staff, Tower Imaging, Los Angeles, California; and Felix S

Chew, MD, EdM, Vice-Chair for Education, Section Head of Musculoskeletal

Radiology, Professor, Department of Radiology, Wake Forest University School of

Medicine

INTRODUCTION Section 2 of 11

Author Information Introduction Differentials X-ray Cat Scan MRI Ultrasound

Nuclear Medicine Intervention Pictures Bibliography

Background: Neuropathic osteoarthropathy can be defined as bone and joint

changes that occur secondary to loss of sensation and that accompany a variety

of

disorders. Charcot first described the relationship between loss of sensation

and arthropathy in 1868. The radiographic changes include destruction of

articular surfaces, opaque subchondral bones, joint debris, deformity, and

dislocation. Neuropathic arthropathy poses a special problem in imaging when it

is

associated with a soft tissue infection.Pathophysiology: The pathophysiology of

neuropathic arthropathy is debatable. The general consensus is that the loss

of proprioception and deep sensation leads to recurrent trauma, which

ultimately leads to progressive destruction, degeneration, and disorganization

of the

joint. Another theory postulates that neurally mediated vascular reflex results

in hyperemia, which can cause osteoclastic bone resorption. Causes of

neuropathic arthropathy include the following:

Diabetes

Use of steroids

Alcoholism

Trauma

Infection

Amyloidosis

Pernicious anemia

Syphilis

Syringomyelia

Spina bifida

Myelomeningocele

Leprosy

Multiple sclerosis

Congenital vascular disease

Charcot-Marie-Tooth disease

Cord compression

Asymbolia

Connective disorders, such as rheumatoid arthritis and scleroderma

Ehlers-Danlos syndrome

Raynaud disease

Adrenal hypercorticism

Thalidomide embryopathy (congenital arthropathy in offspring of exposed

mothers)

Paraneoplastic sensory neuropathy

Cauda equina lipoma