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Charcot's Neuroarthropathy (CN)
What is Charcot's Neuroarthropathy (CN)
Charcot's Neuroarthropathy Definition
Charcot arthropathy is a type of
joint damage, most commonly seen in the foot, that results from diminished
sensation. It is named after Jean-Martin Charcot, a famous French
neurologist of the late 1800s, who recognized that patients with disease
related loss of sensation developed severe joint deformity and destruction.
Charcot's Neuroarthropathy Symptoms and Anatomy
The typical patient has at least some numbness and cannot tell when the foot is overused. The overstressed bones begin to crumble and joint position is lost. The foot may collapse and develop calluses, ulcers, infection, and bone destruction.
- Leading causes of Charcot arthropathy in the foot are:
- Idiopathic (cause not known - spontaneous)
- Heavy metal poisoning
- Vitamin deficiency
- Inherited neurologic disorders
- Nerve damaging infections
Symptoms in the foot of Charcot arthropathy include warmth, redness, swelling, and deep aching pain. These symptoms mimic infection of the foot and Charcot arthropathy are frequently misdiagnosed as "cellulitis".
Initially XRs show slight irregularity of the bones' contour. Later, multiple small fractures, bony overgrowth, and severe deformity of the bone structure with collapse of joint position becomes apparent.
Charcot's Neuroarthropathy Treatment Options
Treatment is rest, immobilization in a boot or cast, elevation, and protected weight bearing with crutches or a scooter. Treatment is continued for many months until the fractures heal and the inflammation and swelling resolves.
Charcot's Neuroarthropathy Surgery
When the bony deformity causes a pressure point, skin calluses and ulcers may occur and lead to deep infection. Then, custom shoe liners (orthotics) are constructed to shield the prominent bony areas or the protruding bone is removed surgically. Occasionally the foot position must be corrected and the foot position stabilized by fusing joints, much like welding the bones together together.