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Charcot Joint (Neuropathic Arthropathy)

Reviewed 06/2018
 


BASICS

In 1703, an English physician, Dr. W. Musgrave, initially described neurogenic arthropathy in a luetic patient, described as a swollen and inflamed joint. French neurologist Jean Martin Charcot...

DIAGNOSIS

Findings frequently confused with cellulitis 

PHYSICAL EXAM

  • Skin erythema, edema, and increased warmth

  • Usually occurs in midfoot

  • Pain is not as severe as physical findings would suggest. Patient...

TREATMENT

GENERAL MEASURES

  • The goal of treatment is to heal broken bones and prevent further deformity, dislocation, and joint destruction. The mainstay therapy is offloading the foot and immobilizatio...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Activity: typically non–weight-bearing initially; regular follow-up with foot care professional 

Patient Monitoring

Repeat imaging (x-ray or MRI) in 4 to 6 weeks. 

PATIENT EDUCATION

REFERENCES

1
Rosenbaum AJ, DiPreta JA. Classifications in brief: Eichenholtz classification of Charcot arthropathy. Clin Orthop Relat Res.  2015;473(3):1168–1171. {L-End} [View Abstract on OvidMe...

ADDITIONAL READING

  • Frykberg RG, Belczyk R. Epidemiology of the Charcot foot. Clin Podiatr Med Surg.  2008;25(1):17–28.

  • Gazis A, Pound N, Macfarlane R, et al. Mortality in patients with diabetic ne...

CODES

ICD10

  • M14.60 Charcot's joint, unspecified site

  • A52.16 Charcot's arthropathy (tabetic)

  • M14.679 Charcot's joint, unspecified ankle and foot

  • M14.671 Charcot's joint, right ankle and foot

  • M14.672 Charcot...

CLINICAL PEARLS

  • Neuropathic arthropathy typically presents with swelling, warmth, and erythema in the feet following a history of trauma.

  • Skin erythema classically resolves with foot elevation in cases...

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