Charcots/neuropathic joints are most commonly seen in September 2007

Ans. A: DM Any condition that causes sensory or autonomic neuropathy can lead to a Charcot joint. Charcot ahropathy occurs as a complication of diabetes, syphilis, chronic alcoholism, leprosy, meningomyelocele, spinal cord injury, syringomyelia, renal dialysis, and congenital insensitivity to pain. Diabetes is considered to be the most common cause of Charcot ahropathy Acute Charcot ahropathy almost always presents with signs of inflammation. Profound unilateral swelling, an increase in local skin temperature (generally, an increase of 3-7 degrees above the nonaffected foot's skin temperature), erythema, joint effusion, and bone resorption in an insensate foot are present. These characteristics, in the presence of intact skin and a loss of protective sensation, are often pathognomonic of acute Charcot ahropathy. Pain can occur in more than 75% of patients; however, the pain's severity is significantly less than would be expected based on the severity of the clinical and/or radiographic findings. Instability and loss of joint function also may be present. Passive movement of the joint may reveal a "loose bag of bones." Approximately 40% of patients with acute Charcot ahropathy have concomitant ulceration, which complicates the diagnosis and raises concerns that osteomyelitis is present.