Case Report of an Unusual Differential Diagnosis of a Red and Atraumatic Swollen Foot Charcot Arthropathy in...

Neuropathic osteoarthropathy of the foot and ankle (Charcot foot) is a disease that can lead to progressive malpositioning and deformation up to complete collapse of the foot. In most cases, diabetic polyneuropathy is the underlying disease, but polyneuropathy of any cause can lead to neuropathic osteoarthropathy. Pathogenesis is still not completely understood. Due to the non-specific clinical presentation, the symptoms of Charcot arthropathy are generally easily misdiagnosed and proper therapy is delayed, especially in patients with an underlying disease other than diabetes mellitus. To date, published literature on patients with rheumatoid arthritis who develop neuropathic osteoarthropathy of the foot is scarce.

We present a rare case of a 61-year-old patient with Charcot foot and rheumatoid arthritis. The patient presented with an extreme foot deformity after a failed conservative treatment. The surgical procedures, complications, and outcome are described. The pitfalls in this special patient group are highlighted.

If necessary, a variety of surgical options are available to maintain ambulation and prevent infection from open ulcers and amputation. For surgical management of patients with rheumatoid arthritis, the overall statics of the lower extremity and the influence of antirheumatic drugs must be considered.