Charcot's joint: an overlooked diagnosis.

Charcot's joint, also known as neuropathic osteoarthropathy, is a common complication of diabetes that often is unrecognized and misdiagnosed. It may be present in up to 35% of patients with diabetic neuropathy. This disorder causes progressive destruction of weight bearing joints leading to dislocations, fractures, and deformities. We report a case of Charcot's joint in a 55-year-old man with type two diabetes. He presented with unilateral foot and ankle swelling, foot pain, warmth, and erythema. A magnetic resonance image of his foot revealed changes consistent with a Charcot's joint. Treatment consisted of joint immobilization in a total contact cast and then an ankle foot orthosis with custom footware. Charcot's joint should be considered in patients with a unilateral, warm, erythematous, swollen foot without other systemic symptoms. Early recognition of a Charcot's joint is important in ultimate outcome. Immobilization of the joint, patient education, and proper footcare and footware are essential in preventing further complications including ulceration and amputation.