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Charcot neuroarthropathy — SCE Endocrinology MCQ

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HardDiabetes complicationsCharcot neuroarthropathySCE Endocrinology

A 49-year-old man with type 2 diabetes has recurrent foot ulceration under the first metatarsal head. The foot is warm with bounding pulses, monofilament is absent and X-ray shows midfoot collapse with fragmentation. CRP is 8 mg/L and he is afebrile. What is the most likely diagnosis?

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Correct answer: D — Acute Charcot neuroarthropathy

Acute Charcot neuroarthropathy is best because a warm swollen neuropathic foot with preserved pulses and bony fragmentation is typical of Charcot neuroarthropathy. The alternatives are less appropriate because necrotising infection and septic arthritis usually have systemic inflammation; ischaemia causes poor pulses; gout does not explain midfoot collapse. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE NG19 diabetic foot problems