Neuroarthropathy associated with chronic alcoholism

Neuroarthropathy involving the feet is seen most commonly in patients with diabetes mellitus. Chronic alcoholism has been implicated as a cause of neuroarthropathy, but many alcoholics have coexistent diabetes mellitus, which may not be detected by measuring blood glucose levels alone. We report five chronic alcoholic patients with neuroarthropathic alterations of the feet in whom coexistent diabetes mellitus was excluded by using laboratory methods that are more sensitive than those employed in previously reported series of alcoholic neuroarthropathy. The radiographic features of neuroarthropathy in our five cases consisted of hypertrophic changes at the tarsal joints in four, bony fragmentation at the tarsal and metatarsal regions in three, fracture dislocation at the tarsometatarsal joint in two, and multiple pathologic fractures in one. We conclude that alcoholism can result in neuroarthropathy in the absence of diabetes mellitus.