Presentation
Chronic left foot deformity, swelling, and hypoesthesia. Known history of long-standing type II diabetes mellitus. History of big toe osteomyelitis since 6 months.
Patient Data
Diffuse erosive/osteoarthritic changes involving all tarsometatarsal (Lisfranc) joints (zone II involvement according to Sanders and Frykberg classification) are seen as articular erosions, subchondral cystic changes, and fragmentation.
Diffuse soft tissue swelling of the mid-foot.
Decreased concavity of the plantar arch is suggestive of secondary pes planus deformity.
Case Discussion
Features are in keeping with Charcot foot (neuropathic arthropathy). The most common cause is diabetes mellitus, which leads to abnormal pain sensation and proprioception. It mainly involves the midfoot with subarticular erosive changes.
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