Charcot joint disease in diabetes mellitus

Vascular surgeons are frequently asked to evaluate diabetic patients with foot problems. While most of these patients present with diabetic foot ulcerations, there is a significant number of patients who have a concomitant Charcot arthropathy. Charcot neuropathic arthropathy, also know as Charcot joint disease (CJD), is a progressive, degenerative arthropathy associated with various types of neuropathic diseases; however, diabetes mellitus is the leading cause of CJD today. CJD targets the joints of the foot, leading to structural foot deformities and a threatened limb. Unfortunately, early signs of the disease are subtle and often go unrecognized until severe structural deformities have occurred. At this stage, the risk of developing pedal ulcerations, osteomyelitis, and a threatened limb has increased significantly. Early detection and immediate treatment of CJD is paramount in preventing the devastating deformities. The purpose of this article is to present a detailed overview of CJD in patients with diabetes mellitus and discuss the pathogenesis, clinical presentation, detection modalities, and various treatment modalities.