Charcot Arthropathy - Foot

• Differential diagnosis

• TB

• Osteomyelitis

• Gout
   

• More than 1/2 have presenting complaint of foot pain despite neurologic impairment
   

• Most common secondary to diabetes

• Rarely syphilis
   

• Sclerosis or lysis near or away from ulceration
   

• Foot frequently shows ulceration
   

• Most difficult differential is from osteomyelitis

• Osteomyelitis usually first involves metaphysis of MT joint
   

• Charcot usually involves MTP joint with astonishing joint destruction on initial radiograph.