A 62-year-old diabetic presents with burning pain of the right foot 3 weeks after an inversion injury of the ankle. Examination reveals flat arches and decreased proprioception bilaterally.

Many joint and musculo-skeletal disorders are associated with broader systemic disease. Charcot arthropathy occurs with the loss of innervation to the joint. In the absence of neurologic input, normal muscle responses that attenuate the wear and damage on a joint are lost. Over time, the joint loses articular cartilage. Additionally, there may be an increase in blood flow and bone resorption in the affected limb, leading to increased risk of bone fractures and injury. Patients may present after an injury from relatively minor trauma, and the degree of pain may be less than anticipated because of the neuropathy. Diabetes mellitus is the most common cause of neuropathic joint.