Acute Charcot arthropathy as a first presentation of type 2 diabetes mellitus

Charcot arthropathy in people with diabetes is generally seen when diabetes has been well established, and therefore it is not routinely considered as a differential diagnosis in people presenting with erythematous and oedematous joints in primary care. We present two cases of acute Charcot arthropathy as a first presentation of type 2 diabetes mellitus. The first case describes a man in his 70s, who presented with a 5-week history of right foot pain, treated initially in the community as cellulitis. A diagnosis of acute Charcot arthropathy was made in the emergency department following review by the orthopaedic and podiatry department. The second case describes a woman in her 40s who presented with a 2-week history of ankle pain. Charcot arthropathy is associated with significant morbidity and mortality, and these cases highlight the importance of including Charcot arthropathy in the differential diagnosis when people present with atypical joint swelling.