Learning Radiology xray montage
 
 
 
 
 

Charcot Arthropathy
Neuropathic Joint

  • Disturbance in sensation leads to multiple microfractures
    • Pain sensation is intact from muscles and soft tissue

  • Distribution and causes

    • Shoulders – syrinx, spinal tumor
    • Hips – tertiary syphilis, diabetes
    • Knees – tertiary syphilis (more bone production), diabetes (less bone production)
    • Feet – diabetes
    • Other causes
      • Amyloidosis
      • Congenital indifference to pain
      • Polio
      • Alcoholism

 

  • Imaging findings

    • Sclerosis
    • Destruction of joint
    • Fragmentation
    • Soft tissue swelling from synovitis
    • Joint effusions
    • Osteophytosis
    • Disorganized and disrupted joint
    • No osteoporosis

charcot knees

Marked sclerosis, fragmentation and joint destruction
are the hallmarks of a neuropathic joint
here caused by syphilis
 

  • DDX

    • Degenerative joint disease
      • Eventually neuropathic joint shows more sclerosis
      • More fragmentation in neuropathic
      • More destruction of bone in neuropathic
    • CPPD
      • Associated with chondrocalcinosis which a neuropathic joint is not