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Review Question - QID 458

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QID 458 (Type "458" in App Search)
You are seeing a 62-year-old male for ankle and foot swelling (Figures A-C). There is no history of trauma and he has never seen a physician before. In addition to his lower extremity care, what other medical condition should he be evaluated for?
  • A
  • B
  • C

Cardiovascular disease

1%

20/3512

Hypertension

0%

11/3512

Diabetes mellitus

96%

3387/3512

Spinal stenosis

1%

20/3512

Rheumatoid arthritis

2%

59/3512

  • A
  • B
  • C

Select Answer to see Preferred Response

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This patient is presenting with Charcot arthropathy, a known complication of diabetes mellitus. Clinical photograph and radiographs show the characteristic appearance of the Charcot foot with complete arch collapse and multi-joint end stage degenerative joint disease through the entire hind, mid, and fore-foot.

As described by Guyton and Saltzman, there is a complex pathophysiology by which diabetes contributes to the foot deformities seen in Charcot arthropathy. This pathophysiology includes alterations in peripheral nerves, bones/soft tissue, gait kinematics, microscopic/macroscopic vascularity, immune system, and mechanisms of wound healing. To treat, one must address the mechanical and biologic aspects of the disease.

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