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Charcot neuroarthropathy — SCE Endocrinology MCQ

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HardDiabetesCharcot neuroarthropathySCE Endocrinology

A 54-year-old man with long-standing type 1 diabetes presents with a warm swollen right foot. He has minimal pain, absent vibration sense and a temperature difference of 3°C compared with the other foot. Foot radiograph is initially normal and CRP is 8 mg/L. What is the most likely diagnosis?

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Correct answer: D — Acute Charcot neuroarthropathy

A warm swollen relatively painless neuropathic foot is Charcot neuroarthropathy until proved otherwise, even when early radiographs are normal. Cellulitis is less likely with minimal systemic inflammation and marked neuropathy, but infection must still be considered. The pearl is urgent offloading, not reassurance from a normal X-ray.

Reference: NICE NG19 diabetic foot guideline