False aneurysm in a Charcot foot: A case report.

Charcot foot or neurogenic osteoarthropathy is a serious complication of diabetic peripheral neuropathy. The association between false aneurysm and Charcot foot is yet uncommon and has not been reported through the literature. We describe a case of false aneurysm in a Charcot foot in a 55-year-old female patient.

CLINICAL CASE

A 55‐year‐old female patient suffering from type 2 diabetes mellitus for 10 years with suboptimal diabetic balance, and with no history of surgery, was admitted to our orthopedic department for a non‐painful swelling on the dorsum of the right foot evolving for 3 months. Physical examination revealed a non‐hot pulsatile swelling of a very deformed right foot with radiographic signs of osteoarticular destruction (Figure 1A,B).

FIGURE 1

(A) Anteroposterior and (B) profile X‐rays view of the right ankle showing signs of osteoarticular destruction (arrows) on a Charcot foot

Regarding the pulsating nature of the swelling, we performed an arteriography that showed a false aneurysm of the dorsal pedal artery in relation to the anterior aspect of the ankle (Figure 2A). The false aneurysm was treated by embolization (Figure 2B).

FIGURE 2

(A) False aneurysm (white arrow) revealed by arteriography and (B) treated by embolization (black arrow)

Only 33 cases of foot and ankle false aneurysms have been reported.  The causes were related to orthopedic foot surgery or ankle sprain. The occurrence of false aneurysm in our case could be explained by low‐energy strain injuries resulting from skeletal abnormalities of the Charcot foot.

The hypothesis of false arterial aneurysm must be a part of the diagnoses to be evoked among infectious or tumoral etiologies because manipulating these false aneurysms surgically can lead to significant bleeding that is difficult to control.

CONFLICT OF INTEREST

None.

AUTHOR CONTRIBUTIONS

Aymen Ben Fredj contributed to writing and editing of the manuscript. Fourat Farhat contributed to conceptualization of the manuscript. Hedi Rbai contributed to supervision and validation.

ETHICAL APPROVAL

This clinical image is the authors' own original work, which has not been previously published elsewhere.

CONSENT

A written informed consent was obtained from the patient to publish this report in accordance with the journal's patient consent policy.