Charcot joint is the swelling of joints due to progressive deteriorating disease. It is caused due to hemorrhage or infection on the joints. Charcot joint disease is also called as neurogenic arthropathy. The joints get affected due to underlying neurologic disorder like diabetes, Leprosy which may damage the nerve endings. The affected person may not have any pain on the joint initially due to numbness caused by nerve damage.
It was Dr. Jean Marie Charcot from France who discovered this disease in patients with Syphilis in the year 1868. Hence the name Charcot is given for this disorder.
Symptoms :
The joints that are cut off from nerve supply are seriously affected. The consistent nerve damage can have impact on the bones, cartilages and tissues. The bones of the affected area may get distorted and the cartilages move from its position causing more damage. This disease affects the knee joint or ankle joint predominantly.
The affected joint will become swollen and unstable causing nerve damage and loss of sensation.
Initially there may not be any pain except swelling of joints due to inflammation. Diabetic patients are more prone to this disease than others and it is better to monitor any changes in their joints and foot area.
Causes :
Diabetic neuropathy is the main cause for Charcot joint disease. It is caused by increased blood sugar which would deactivate the nerve endings of the joint.
Some of the other factors that cause this disease are syphilis infection, leprosy, alcoholic neuropathy, Cerebral Palsy, spinal cord problems and kidney disease.
Often it affects both the feet in men and women. About 60-70% of the people diagnosed with Charcot joint are diabetic. Aged people are more risky for getting this problem due to diabetics.
For some it may occur as side effect of fracture, disability, gangrene, ulcers on the skin and during joint replacement surgery.
Who are at risk?
People with chronic diabetes are under high risk of getting Charcot joint. One in every 500 persons with diabetics will get this problem. People with problems like leprosy, autoimmune disorders, syphilis and Multiple Sclerosis are also more prone to get this disease.
Individuals with history of knee injury or trauma and surgery are also under risk. Since pain is not felt due to nerve damage, the person will continue to walk and run normally making the condition still worse.
Diagnoses :
The doctor will physically examine the knee area and affected ankle. He may order for blood sugar test for confirming diabetics. He may order for CT scan to assess the intensity of joint damage.
Treatment :
Your doctor will identify the cause to start with treatment. Drugs or injections are given to control blood sugar level for diabetic patients.
To alleviate the pain, the patient will have to use crutches or cane for support while walking. Ensure that you are not putting more weight on the joints. For some people, removable cast is placed for immobilizing the foot. You should use braces or cast for long time depending upon the intensity of damage caused and the length of joint damaged.
Special shoes are to be used for preventing foot ulcers.
The best treatment for Charcot joint is to take complete rest. Surgery is the last option and does not provide total cure. In severe case, amputation of the feet is done to prevent further damage to the adjacent joints.
NSAID medications are given to reduce pain and swelling. The affected person should use walker or crutches to prevent more pressure on the joints.
In rare cases, joint replacement surgery is done. Reconstructive surgery is done on the foot or ankle in case of severe damage to prevent leg amputation.
