N is for neuropathic arthropathy

May 12, 2013

Neuropathic arthropathy is the joint destruction that happens most common in diabetes when there is damage to a joint if there is also impaired sensation from the nerves. It is also called Charcots foot.

neuropathic arthropathy

Neuropathic arthropathy, also known as Charcot joint or Charcot arthropathy, is a condition characterized by progressive degeneration of a joint due to underlying neuropathy (nerve damage). It most commonly affects the feet and ankles, but can also occur in other joints of the body. Neuropathic arthropathy is typically associated with conditions that cause sensory and autonomic neuropathy, such as diabetes mellitus.


  1. Diabetes Mellitus: Diabetes is the most common cause of neuropathic arthropathy. Prolonged high blood sugar levels can damage the nerves, leading to loss of sensation and proprioception (awareness of joint position). Without proper feedback, the joint may be subjected to repetitive trauma and stress, resulting in degeneration.
  2. Other Neuropathic Conditions: Neuropathic arthropathy can also occur in other conditions that cause peripheral neuropathy, such as syphilis, leprosy, spinal cord injury, alcoholism, and certain genetic disorders.


  1. Joint Deformity: Neuropathic arthropathy often leads to joint deformities characterized by swelling, redness, and warmth. The joint may become misaligned or dislocated, leading to a rocker-bottom appearance in severe cases.
  2. Loss of Sensation: Patients with neuropathic arthropathy typically have decreased or absent sensation in the affected joint. This loss of protective sensation contributes to the development of joint damage and increases the risk of unnoticed injuries.
  3. Progressive Nature: Neuropathic arthropathy is a chronic and progressive condition. The joint damage tends to worsen over time if left untreated, leading to further deformity, instability, and functional impairment.

Diagnosis and Treatment:

  1. Clinical Evaluation: A healthcare professional will assess the patient’s medical history, symptoms, and perform a physical examination to evaluate joint deformities, loss of sensation, and signs of inflammation.
  2. Imaging Studies: X-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scans may be used to visualize joint changes, including bone destruction, fractures, and dislocations.
  3. Conservative Management: Non-surgical treatment focuses on relieving symptoms, protecting the affected joint, and promoting stability. This may involve immobilization with casts or braces, offloading with orthotic devices, pain management, and the use of assistive devices.
  4. Surgical Intervention: In severe cases where conservative measures fail, surgical intervention may be necessary to correct deformities, stabilize the joint, and provide pain relief. Surgical options include joint realignment, fusion, or joint replacement.
  5. Underlying Condition Management: Addressing the underlying neuropathic condition, such as achieving optimal blood sugar control in diabetes, is essential to prevent further nerve damage and halt the progression of neuropathic arthropathy.


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