Charcot's joints
Chronic progressive degeneration of the stress-bearing portion of a joint, with bizarre
hypertrophic changes at the periphery. It is probably a complication of a variety of
neurologic disorders, particularly TABES DORSALIS, involving loss of sensation, which
leads to relaxation of supporting structures and chronic instability of the joint
Description of Charcot's joints
Charcot's joints, also called neuropathic joint disease, is the result of two
conditions present in the joint. The first factor is the inability to feel pain in the
joint due to nerve damage. The second factor is that injuries to the joint go unnoticed
leading to instability and making the joint more susceptible to further injury. Repeated
small injuries, strains and even fractures can go unnoticed until finally the joint is
permanently destroyed. Loss of the protective sensation of pain is what leads to the
disintegration of the joint and often leads to deformity in the joint.
Although this condition can affect any joint, the knee is the joint most commonly
involved. In individuals with diabetes mellitus, the foot is most commonly affected. The
disease can involve only one joint or it may affect two or three joints. More than three
affected joints is very rare. In all cases, the specific joint(s) affected depends on the
location of the nerve damage.
Causes & symptoms of Charcot's joints
Many diseases and injuries can interfere with the ability to feel pain. Conditions such
as diabetes mellitus, spinal injuries and diseases, alcoholism, and even syphilis can all
lead to a loss of the ability to feel pain in some areas. Lack of pain sensation may also
be congenital.
The symptoms of Charcot's joints can go unnoticed for some time and may be confused
with osteoarthritis in the beginning. Swelling and stiffness in a joint without the
expected pain, or with less pain than would be expected, are the primary symptoms of this
condition. As the condition progresses, however, the joint can become very painful due to
fluid build-up and bony growths.
Diagnosis of Charcot's joints
Charcot's joints is suspected when a person with a disease that impairs pain sensation
exhibits painless swelling and/or stiffness in a joint. Standard x rays will show damage
to the joint, and may also show abnormal bone growth and calcium deposits. Floating bone
fragments from previous injuries may also be visible.
Treatment of Charcot's joints
In the early stages of Charcot's joints, braces to stabilize the joints can help stop
or minimize the damage. When the disease has progressed beyond braces, surgery can
sometimes repair the joint. If the damage is extensive, an artificial joint may be
necessary.
Prognosis
Treatment of the disease causing loss of pain perception may help to slow the damage to
the joints.
Prevention
Preventing, or effectively managing the underlying disease can slow or in some cases
reverse joint damage, but the condition cannot be prevented. |
