Neuropathic Osteoarthropathy

Neuropathic osteoarthropathy, also referred to as Charcot arthropathy, is a neurodegenerative and traumatic condition affecting joints around the body, arising in a number of conditions with a common etiology including loss of sensation. Most commonly, Charcot arthropathy involves the foot in patients with advanced or poorly controlled diabetes mellitus. A constellation of clinical findings ensues, initially presenting with a hot, swollen erythematous foot, later presenting with deformity and collapse of the arch of the foot. Imaging exams show characteristic findings including joint deformity, bone destruction, and malalignment. Deformity can lead to ulcer formation and superimposed infection. This chapter will address the pathoetiology, imaging findings, and differential diagnosis.