IMAGE OF THE WEEK 2012

WEEK 31

 

Charcotís Foot

 

 

Figure 1: X-ray of the feet showing Charcot's joint deformity.

(Click on image to enlarge)

Figure 2: Annotated x-ray of the feet showing Charcot's joint deformity.

(Click on image to enlarge)

 

 

A Charcot joint (neuropathic joint) is due to a progressive destructive joint disorder in patients with impaired pain sensation and proprioception.  In contemporary medicine, particularly when involving the foot/ankle, this is due to longstanding diabetes.

The 2 theories for the pathophysiology of this condition are the neuro-traumatic theory in which repeated trauma with no sensory feedback occurs and the neurovascular theory in which the absence of neural stimuli results in vasodilatation and hyperemia which promotes bone resorption.

Other less common causes aside from diabetes include the D Sís:

Syphilis

Steriods

Spinal Cord Injury

Syringomyelia

Spina Bifida

Scleroderma

On plain film radiography it is characterised by multiple findings, remembered as the 6 Dís:

Dense bones (sub-chondral sclerosis)

Degeneration

Destruction

Deformity

Debris (loose bodies)

Dislocation

 

Images and text contributed and prepared by

Dr Ian Bickle, Department of Radiology.

All images are copyrighted and property of RIPAS Hospital.

 

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