What are the signs and symptoms of Charcot arthropathy?

Updated: Jun 21, 2018
  • Author: Mrugeshkumar Shah, MD, MPH, MS; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

The clinical presentation of Charcot arthropathy can vary widely depending on the stage of the disease. Thus, symptoms can range from mild swelling and no deformity to moderate deformity with significant swelling.

Acute Charcot arthropathy almost always presents with signs of inflammation. Profound unilateral swelling, an increase in local skin temperature (generally, an increase of 3-7º above the unaffected foot's skin temperature), erythema, joint effusion, and bone resorption in an insensate foot are present. These characteristics, in the presence of intact skin and a loss of protective sensation, are often pathognomonic of acute Charcot arthropathy.

Pain can occur in more than 75% of patients; however, the pain's severity is significantly less than would be expected from the severity of the clinical or radiographic findings. Instability and loss of joint function also may be present. Passive movement of the joint may reveal a "loose bag of bones." Approximately 40% of patients with acute Charcot arthropathy have concomitant ulceration, which complicates the diagnosis and raises concerns that osteomyelitis is present.


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