Neuropathic arthropathyCharcot joints
Dr / Hytham Nafady
Beyond the classic Ds
• Destruction.
• Dislocation.
• New bone formation.
• Debris.
Neuropathic osteoarthropathy
• represents a spectrum of bone and joint destructive processes associated with neurosensory deficit.
Etiology
• Loss of proprioceptive sensation.
Spinal cord Peripheral nerves
Syringomyelia.
Syphilis (tabes dorsalis).
Spinal cord tumors.
Myelomeningocele.
Cord compression.
MS.
Diabetes.
Leprosy.
Peripheral nerve tumors.
Radiological patterns
Hypertrophic pattern
• Joint destruction.
• Fragmentation.
• Osseous sclerosis.
• Dislocation.
• Joint effusion.
• Debris.
Atrophic pattern
• Osseous resorption (that resembles surgical amputation).
• Joint dislocation.
• Joint debris.
Shoulder neuropathic arthropathy
Debris
Dislocation
Destruction
Debris
Debris
Debris
Dislocation
Destruction
Spine neuropathic arthropathy
DD (Spondylodiscitis)Neuropathic arthropathy Spondylodiscitis
Destruction involves the three vertebral columns including the facet joints.
Destruction of the anterior vertebral column only.
Sclerosis & destruction involve the whole vertebral body.
Sclerosis & destruction is limited to the vertebral end plates.
Paraspinal soft tissue debris.
Paraspinal soft tissue calcification (only with granulomatous infection)
Foot neuropathic arthropathy
Lisfrank fracture dislocation
Homolateral Lisfrank fracture
dislocation
Divergent Lisfrank fracture
dislocation
Hand neuropathic arthropathy
Knee neuropathic arthropathy