Dr. M.J. Bazos, MD
Patient Handout
CHARCOT
JOINT
About Your
Diagnosis
Charcot joint is a destructive process that
primarily affects joints in the weight-bearing extremities, such as the feet,
ankles, knees, and possibly hips. Many times a Charcot joint can be confused
with an infection involving these areas, and it may be difficult for your
physician to differentiate these two conditions. By definition, a patient with a
Charcot joint has decreased sensation in the affected area and peripheral
neuropathy, which is most commonly due to diabetes. There are other causes of
peripheral neuropathy. However, they are much less common than diabetes. As a
result, it is common for persons with diabetes to experience peripheral
neuropathy first, which is followed by Charcot joint. A high index of suspicion
is generally required to make the diagnosis early in the disease process. A
person with Charcot joint experiences swelling, pain, and increased skin
temperature over the affected joint or joints. These are the same signs and
symptoms that occur with infections, so this cause has to be considered as well.
The use of weight-bearing or standing radiographs (x-rays) is essential not only
to establish the diagnosis but also to determine the degree of destruction of
the joints. Most patients with Charcot joint have acute inflammation without a
history of trauma or cut or break in the skin, which would suggest an infection.
Charcot joint is generally considered treatable but not
curable.Living With Your
DiagnosisPrevention is the key to
minimizing the deformities that can occur. At the earliest onset of swelling,
redness, and increased skin temperature directly over an affected joint or
joints, contact your doctor. Ignoring the warning signs may lead to destruction
of the joints with disintegration of the bones and collapse (Fig 1). Many times
Charcot joint is an extremely painful condition, even though it occurs in areas
affected by peripheral neuropathy. Persons with this severe pain usually seek
treatment sooner than persons with little pain, who often do not seek treatment
until the deformity becomes severe.
TreatmentThere
are no medications available specifically to treat Charcot joint. The acute
inflammatory phase is managed with immobilization of the extremity and use of
crutches or a walker to decrease weight bearing or eliminate weight bearing
through the extremity. It can take as long as 6 weeks for the acute inflammation
to subside. After the inflammation subsides, the joint or joints are braced and
likely require bracing or other support to prevent further flare-ups and
destruction of the joints.The
DOs• Control your diabetes with
proper medication, diet, and
exercise.•Ê Should a Charcot
joint develop, modify the exercise program to eliminate weight bearing.
Substitute non<en>weight-bearing forms of exercise, such as cycling or
water exercises.The
DON’Ts• Do not begin an
aggressive walking or running program immediately after being fitted with braces
or splints.When to Call Your
Doctor• If you notice the
recurrence of swelling, heat, or redness around any weight-bearing joint,
particularly if it recurs in a joint that was
treated.Websites:http://www.merk.com/!!tKbSq1RNKtKbSq1RNK/pubs/mmanual/html/qmifigdb.htmhttp://bio-3.bsd.uchicago.edu/~cppweb/cases/Neuropathicarthritis.html