Presentation
Red, hot, swollen left foot. Minor Pain – No trauma. Poorly controlled type 2 diabetes.
Patient Data
AP and lateral plain foot radiographs in a diabetic patient with chronic neuropathic arthropathy. Destruction of the tarsometatarsal (Lisfranc) joint. Periosteal reaction and new bone formation at the 1st metatarsal which remains congruent (No subluxation). Surrounding soft tissue swelling is present. Loose bodies are seen on the lateral view.
All these features are consistent with Charcot foot.
Case Discussion
Charcot joint involving foot is a progressive degenerative/destructive joint disorder in patients with abnormal pain sensation and proprioception. It is most commonly secondary to diabetes.
Mnemonic - 6 Ds of Charcot joint
- dense bones (subchondral sclerosis)
- degeneration
- destruction of articular cartilage
- deformity (pencil-point deformity of metatarsal heads)
- debris (loose bodies)
- dislocation