What causes Charcot arthropathy?

Answer

Any condition that causes sensory or autonomic neuropathy can lead to a Charcot joint. Charcot arthropathy occurs as a complication of diabetes, syphilis, chronic alcoholism, leprosy, meningomyelocele, spinal cord injury, syringomyelia, renal dialysis, and congenital insensitivity to pain. Diabetes is considered to be the most common cause of Charcot arthropathy.^[6]There is also evidence for a relationship between Charcot arthropathy and rheumatoid arthritis.^[7]

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Kelly M. William Musgrave’s De Arthritide Symptomatica (1703): His description of neuropathic arthritis. Bull Hist Med. 1963. 37:372-6.
Charcot JM. Sur quelaques arthropathies qui paraissent depender d’une lesion du cerveau ou de la moele epiniere. Arch Des Physiol Norm et Path. 1868. 1:161-71.
Saunders LJ, Mrdjencovich D. Anatomical patterns of bone and joint destruction in neuropathic diabetics. Diabetes. 1991. 40:529A.
Schon LC, Easley ME, Weinfeld SB. Charcot neuroarthropathy of the foot and ankle. Clin Orthop Relat Res. 1998 Apr. (349):116-31. [Medline].
Jansen RB, Svendsen OL. A review of bone metabolism and developments in medical treatment of the diabetic Charcot foot. J Diabetes Complications. 2018 Jul. 32 (7):708-712. [Medline].
van der Ven A, Chapman CB, Bowker JH. Charcot neuroarthropathy of the foot and ankle. J Am Acad Orthop Surg. 2009 Sep. 17 (9):562-71. [Medline].
Grear BJ, Rabinovich A, Brodsky JW. Charcot arthropathy of the foot and ankle associated with rheumatoid arthritis. Foot Ankle Int. 2013 Nov. 34 (11):1541-7. [Medline].
Stark C, Murray T, Gooday C, Nunney I, Hutchinson R, Loveday D, et al. 5 year retrospective follow-up of new cases of Charcot neuroarthropathy-A single centre experience. Foot Ankle Surg. 2016 Sep. 22 (3):176-80. [Medline].
Lee M, Choi WJ, Han SH, Jang J, Lee JW. Uncontrolled diabetes as a potential risk factor in tibiotalocalcaneal fusion using a retrograde intramedullary nail. Foot Ankle Surg. 2018 Dec. 24 (6):542-548. [Medline].
Panchbhavi VK, Villarreal AD. Treatment of acute Lisfranc fracture and dislocation in patients with neuropathy. Tech Foot Ankle Surg. 2010. 9 (3):115-22.
Schlossbauer T, Mioc T, Sommerey S, Kessler SB, Reiser MF, Pfeifer KJ. Magnetic resonance imaging in early stage charcot arthropathy: correlation of imaging findings and clinical symptoms. Eur J Med Res. 2008 Sep 22. 13 (9):409-14. [Medline].
Ulbrecht JS, Wukich DK. The Charcot foot: medical and surgical therapy. Curr Diab Rep. 2008 Dec. 8 (6):444-51. [Medline].
Grant WP, Garcia-Lavin SE, Sabo RT, Tam HS, Jerlin E. A retrospective analysis of 50 consecutive Charcot diabetic salvage reconstructions. J Foot Ankle Surg. 2009 Jan-Feb. 48(1):30-8. [Medline].
Simon SR, Tejwani SG, Wilson DL, Santner TJ, Denniston NL. Arthrodesis as an early alternative to nonoperative management of charcot arthropathy of the diabetic foot. J Bone Joint Surg Am. 2000 Jul. 82-A (7):939-50. [Medline].
Schneekloth BJ, Lowery NJ, Wukich DK. Charcot Neuroarthropathy in Patients With Diabetes: An Updated Systematic Review of Surgical Management. J Foot Ankle Surg. 2016 May-Jun. 55 (3):586-90. [Medline].
Wang Y, Zhou J, Yan F, Li G, Duan X, Pan H, et al. Comparison of Arthrodesis with Total Contact Casting for Midfoot Ulcerations Associated with Charcot Neuroarthropathy. Med Sci Monit. 2015 Jul 24. 21:2141-8. [Medline]. [Full Text].
Verity S, Sochocki M, Embil JM, Trepman E. Treatment of Charcot foot and ankle with a prefabricated removable walker brace and custom insole. Foot Ankle Surg. 2008. 14 (1):26-31. [Medline].
Guis S, Pellissier JF, Arniaud D, Turck F, Witjas T, Roux H, et al. Healing of Charcot's joint by pamidronate infusion. J Rheumatol. 1999 Aug. 26 (8):1843-5. [Medline].
Selby PL, Young MJ, Boulton AJ. Bisphosphonates: a new treatment for diabetic Charcot neuroarthropathy?. Diabet Med. 1994 Jan-Feb. 11 (1):28-31. [Medline].
Strauss E, Gonya G. Adjunct low intensity ultrasound in Charcot neuroarthropathy. Clin Orthop Relat Res. 1998 Apr. (349):132-8. [Medline].
Wirth SH, Espinosa N, Berli M, Jankauskas L. [Complex reconstruction in Charcot arthropathy using the Ilizarov ring fixator]. Orthopade. 2015 Jan. 44 (1):50-7. [Medline].
Sohn MW, Stuck RM, Pinzur M, Lee TA, Budiman-Mak E. Lower-extremity amputation risk after charcot arthropathy and diabetic foot ulcer. Diabetes Care. 2010 Jan. 33 (1):98-100. [Medline]. [Full Text].
Dalla Paola L, Brocco E, Ceccacci T, Ninkovic S, Sorgentone S, Marinescu MG, et al. Limb salvage in Charcot foot and ankle osteomyelitis: combined use single stage/double stage of arthrodesis and external fixation. Foot Ankle Int. 2009 Nov. 30 (11):1065-70. [Medline].
Hegewald KW, Wilder ML, Chappell TM, Hutchinson BL. Combined Internal and External Fixation for Diabetic Charcot Reconstruction: A Retrospective Case Series. J Foot Ankle Surg. 2016 May-Jun. 55 (3):619-27. [Medline].
Lamm BM, Gottlieb HD, Paley D. A two-stage percutaneous approach to charcot diabetic foot reconstruction. J Foot Ankle Surg. 2010 Nov-Dec. 49 (6):517-22. [Medline].
Miller RJ. Neuropathic Minimally Invasive Surgeries (NEMESIS):: Percutaneous Diabetic Foot Surgery and Reconstruction. Foot Ankle Clin. 2016 Sep. 21 (3):595-627. [Medline].
[Guideline] Diabetic foot problems: prevention and management. National Institute for Health Care and Excellence. Available at https://www.nice.org.uk/guidance/ng19/chapter/Recommendations#treatment-2. October 2019; Accessed: March 23, 2020.

Media Gallery

Neuropathic arthropathy (Charcot joint). Neuropathic arthropathy of shoulder in patient with syringomyelia. Note destruction of articular surface, dislocation, and debris, which are pathognomonic for neuropathic joint.
Ankle fracture in 65-year-old diabetic patient.
Ankle fracture fixed by using augmented fixation technique.
Midfoot acute Charcot arthropathy.
Charcot arthropathy. Follow-up at 6 months after internal fixation with "beaming" screws.
Severe fracture dislocation of ankle.
Hindfoot stabilized with hindfoot arthrodesis intramedullary rod.

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Author

Mrugeshkumar Shah, MD, MPH, MS Staff Physician, Physical Medicine and Rehabilitation, Massachusetts General Hospital/Spaulding Rehabilitation Hospital

Mrugeshkumar Shah, MD, MPH, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Coauthor(s)

Walter Panis, MD Clinical Instructor, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School

Walter Panis, MD is a member of the following medical societies: American Academy of Neurology, American Society of Neurorehabilitation, Massachusetts Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS Professor of Orthopedic Surgery, Chief, Division of Foot and Ankle Surgery, Director, Foot and Ankle Fellowship Program, Department of Orthopedic Surgery, University of Texas Medical Branch School of Medicine

Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Orthopaedic Trauma Association, Texas Orthopaedic Association

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Styker.

Additional Contributors

James K DeOrio, MD Professor of Orthopedics, Director, Duke Foot and Ankle Fellowship, Duke University Medical Center, Duke University School of Medicine; Associate Professor, Mayo Clinic College of Medicine; Clinical Assistant Professor, F Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences

James K DeOrio, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Foot and Ankle Society, Association of Graduates, United States Air Force Academy, Doctors Mayo Society, Mayo Clinic Alumni Association, Society of Air Force Clinical Surgeons, Society of Military Orthopaedic Surgeons

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Exactech; Treace Medical; Additive; Mirus<br/>Serve(d) as a speaker or a member of a speakers bureau for: Exactech; Treace Medical; Additive; Mirus; WoultersKluwer.

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