Search This Blog

Sunday, July 25, 2010

Neuropathic Joint – Chronic

Neuropathic Joint – Chronic
July 24, 2010Musculoskeletal
55 years old MaleFindings, summary, final Dx?
Thumbnail imageThumbnail imageThumbnail image
Answers:

Neuropathic Joint – Chronic:
  • The first image (above, left) showed evidence of a longstanding lisfranc fracture-dislocation with extensive eburnation and fragmentation around the metatarsal joints
  • Remaining images showed similar changes in the spine and knee
  • All these findings are consistent with a Neuropathic (Charcot) joint in the late-stage
  • The Neuropathic Joint has been called “Osteoarthritis with a Vengeance” – nothing else causes as severe destruction
Thumbnail image
  • D’s of the late-stage Neuropathic Joint (De3nse subchondral bone, Destruction of articular cortex, Deformity, Debris (loose bodies), and Dislocation)
  • Diabetes is the most common cause, even though it occurs in only 5 to 10 % of diabetics
  • Again, Remember the causes: “DS6” (Diabetes, Syphilis, Steroids, Spinal Cord Injury, Spina Bifida, Syringomyelia, Scleroderma)
Thumbnail imageThumbnail image
  • In the case an examiner asks: a Lifranc fracture-dislocation is a Tarsometatarsal dislocation (as shown above)
  • A Chopart fracture-dislocation involves the hindfoot-midfoot joint, i.e., tarsonavicular and calcaneocuboid joints

No comments:

Post a Comment