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