Radiologic case study. Neuropathic osteoarthropathy

Diabetic osteoarthropathy is the most common neuropathic condition seen clinically in the foot. It can develop rapidly with a time course of weeks to months. Soft tissue swelling and erythema with deformity are noted clinically, usually with decreased pain sensation. However, it is important to realize that these patients frequently do have pain; it may only be disproportionate to the degree of injury. Radiographic diagnosis can predate clinical suspicion and is based on recognizing the resorptive and the productive patterns of the osteoarthropathy. Often, the first clue is recognizing the radiographic features of joint instability. Remembering that overt trauma may precipitate neuropathic osteoarthropathy will also help its recognition in the follow up of fractures.