Charcot osteo-arthropathy

Abstract

Charcot osteo-arthropathy is a potentially catastrophic complication of neuropathy. It can occur in any joint and has been associated with many of the causes of sensory deprivation; however it most commonly presents in the foot and ankle in the diabetic population. This article stresses early recognition and prevention of deformity. The key topics are: Pathophysiology: unrecognised microtrauma versus osseous hyperaemia as likely aetiologies, leading to fragmentation of the affected joint or bone. Assessment: diagnosis of neuropathy, x-ray changes, alternative imaging and its limitations and investigation to rule out other causes. Classification and staging: current staging of Charcot osteo-arthropathy and anatomical classification of foot and ankle Charcot osteo-arthropathy. Treatment: Current recommended treatment modalities including conservative, operative and pharmacological.