A 52-year-old woman with a 15-year history of type 2 diabetes develops a painless, warm, swollen foot with architectural collapse of the mid-foot. X-ray shows extensive joint destruction, fragmentation, and periarticular sclerosis with a 'bag of bones' appearance. The diagnosis is:
- A Septic arthritis of the tarsometatarsal joint
- B Osteosarcoma of the mid-foot
- C Charcot neuroarthropathy (Charcot foot) ✓
- D Rheumatoid arthritis of the foot
Correct answer: C. Charcot neuroarthropathy (Charcot foot)
Explanation
Charcot neuroarthropathy results from peripheral neuropathy causing repeated, unperceived micro-trauma leading to progressive joint destruction, fracture, and architectural collapse. The painless nature despite severe destruction is pathognomonic. The Eichenholtz Stage I (development) shows acute inflammation; Stage II (coalescence) shows resorption and fragmentation; Stage III (reconstruction) shows sclerosis and 'bag of bones.' Treatment in the active phase is total contact casting; late deformity with instability may require surgical reconstruction.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.