Charcot arthropathy: The diagnostic dilemma of a painless, destructive joint

Galanis, Nikiforos; Kyriakou, Aikaterini; Delniotis, Ioannis; Charanidi, Paraskevi; Mavropoulos, Paraskevas; Inklebarger, James

doi:10.1002/ccr3.2603

Cited by 1 publication

(1 citation statement)

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“…It is thus perhaps unsurprising that this particular diabetic complication is in itself frequently misdiagnosed 12. Infection is the most common mimic that requires consideration, but this case highlights the need to maintain a wide differential, including malignancy; misdiagnosis of Charcot arthropathy can have a significant effect on survival 13. Given the difficulty separating the radiological features of a Charcot joint from infection and malignancy, even with the combined interpretation of specialists as evidenced in this case, it is fair to conclude that a swollen joint in a diabetic patient warrants a thorough and extensive workup (possibly including tissue sampling) for a definitive diagnosis to be made.…”

Section: Discussionmentioning

confidence: 97%

Pedal acrometastasis secondary to urothelial carcinoma masquerading as Charcot arthropathy in a patient with diabetes

Coe,

Chirputkar,

Joseph

et al. 2023

BMJ Case Rep

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A woman in her 80s with known diabetes mellitus and bladder cancer presented to her general practitioner (GP) with pain and swelling in her left foot following trauma. Initial radiographs were reported as normal, prompting a diagnosis of a simple sprain and conservative management. Three months later, the patient was referred to the orthopaedic team due to progressively increasing pain and swelling. Repeat X-rays revealed lytic lesions in both the talus and navicular bones; MRI confirmed the presence of a lytic and proliferative defect in the mid-foot, which was reported as acute Charcot arthropathy with superimposed infection. This was also considered the most likely diagnosis when imaging was reviewed in two separate multidisciplinary team) meetings. However, biopsy demonstrated that the cause of the presentation was in fact acrometastasis from urothelial carcinoma, an infrequently described entity.

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Section: Discussionmentioning

confidence: 97%