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Charcot neuroarthropathy versus osteomyelitis: a case series
Hau T Pham1, Elizabeth Sanders1, Ewald R Mendeszoon1
1Boston Medical Center, Boston, MA; Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
Introduction:
Patients with diabetes and peripheral neuropathy have a 25% risk of developing a foot ulcer, and these can lead to soft tissue infections that worsen and result in osteomyelitis. While Charcot neuroarthropathy is not as common as osteomyelitis, it is often misdiagnosed as osteomyelitis.
Case Reports:
Three patients presented with diabetes, neuropathy, and foot ulcers. They underwent prophylactic surgery but later developed swelling at the surgical sites. Radiographs showed fragmentations that caused concern about osteomyelitis. The authors maintained diagnoses of Charcot neuroarthropathy and treated the patients with immobilization and offloading. All patients resolved the fragmentations without antibiotics or surgery.
Conclusion:
While Charcot neuroarthropathy and osteomyelitis have similar signs and symptoms, understanding the similarities and differences between the conditions can aid providers in appropriate wound management.
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