Neurogenic Arthropathy (Charcot Joint)

Joint destruction resulting from loss or diminution of proprioception, pain, and temperature perception

As normal muscle tone and protective reflexes are lost, secondary degenerative joint disease ensues

Although initially described in the knees of patients with tabes dorsalis, it is now more frequently seen in association with diabetic neuropathy (foot and ankle) or syringomyelia (shoulder)

An enlarged, boggy, relatively painless joint with extensive cartilage erosion, osteophyte formation, and multiple loose-joint bodies

Radiographs can reveal striking osteolysis that mimics osteomyelitis or dramatic destruction of the joint with subluxation, fragmentation of bone, and bony sclerosis

Differential diagnosis

• Repeated trauma (causing degenerative joint disease)

• Rheumatoid arthritis

• Chronic hemarthrosis (bleed)

• Chondrocalcinosis (eg, pseudogout, hemochromatosis, Wilson disease)

Directed toward the primary disease

Mechanical devices are used to assist in weight bearing and prevention of further trauma

In some instances, amputation becomes unavoidable