JOINT DISEASE (CHARCOT JOINT) articular degeneration secondary to weight-bearing
trauma and neurovascular changes on sensory deficient joint, resulting in
bony resorption and formation.
Bilateral metatarsophalangeal joint involvement is common,
especially among diabetics. The second tarso metatarsal joint is a frequent
site for early subluxations. Mono- or polyarticular interphalangeal joint
or midfoot presentations may also occur.
Osteophytes, joint effusions, and soft tissue swelling
are among the common early findings. Later in the disease process, acute fractures,
dislocations, and subluxations may occur. Subluxations at the tarso metatarsal
joints may mimic Lisfranc fracture/subluxations. Frequent fractures include
subchondral fractures of the second metatarsal head, and avulsion fractures
of the posterior calcaneal tubercle. Tapering osteolysis ("sucked candy" or
"pencil-pointing"), bony fragmentation with well defined margins, and fusions
with or without pseudoarthroses are other signs of progression.
Joint space narrowing and bony fragmentation may mimic
early osteoarthritis. Osteophyte formation tends to be more aggressive than