Which procedures are performed in the workup 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

Lumbar puncture is used if the RPR test is positive. An FTA-ABS test is ordered if tertiary syphilis/tabes dorsalis is suggested.

Bone probing is done with a blunt, sterile surgical probe. If the probe can be passed down to bone or if the underlying bone is exposed at the base of an ulcer or sinus, the bone is infected; this establishes the diagnosis of osteomyelitis.

Portable infrared dermal thermometry is used for skin temperature assessment. It can be used to monitor active inflammation. A 3-5° difference is generally seen in the acute stage.

Joint aspiration is used to help rule out a septic joint.

Synovial biopsy can be helpful. Small fragments of bone and cartilage debris are embedded in the synovium because of joint destruction. Some state that this is pathognomonic, whereas others state that it is highly suggestive of Charcot arthropathy.


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