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Charcot Neuroarthropathy — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesCharcot NeuroarthropathyRACP Adult Medicine

A 55-year-old woman with diabetes presents with an erythematous, warm, swollen left midfoot without an obvious wound. She has peripheral neuropathy. X-ray shows midfoot fragmentation, subluxation, and periarticular debris. She is afebrile and inflammatory markers are only mildly elevated. What is the most likely diagnosis?

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Correct answer: E — Charcot neuroarthropathy

An acutely swollen, warm foot in a diabetic patient with neuropathy and without wound/fever — plus characteristic X-ray findings of midfoot fragmentation, subluxation, and debris — is Charcot neuroarthropathy (neuropathic osteoarthropathy). The midfoot (Lisfranc joint) is most commonly affected. Treatment is offloading and immobilisation.

Reference: eTG Endocrine – 2024 – Diabetic Foot; ADS 2024