Acute Clinical Presentation of Charcot Arthropathy

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Selected ACL cases November 2006 through January 2008 November 2006 through January 2008
Case #1 55 y/o diabetic male – presented to ER c c/o R lower leg and foot swollen and painful since previous evening. No known MOI. PMH: DM, HTN, ESRD (PD), PVD, Peripheral neuropathy Upon further questioning, pt remembered having increasing leg and foot swelling x 2-3 weeks. PT staff called to come give assessment and recommendations. Pt had edema in R lower leg and ‘bowing out’ of plantar surface of foot. No increased warmth, redness, wounds, or drainage. Recommendation: send pt to radiology for foot and ankle films to r/o Charcot foot – presentation not consistent c cellulitis. PT Rx: Pt issued Ace wrap to try and help control swelling in R LE. Pt instructed on treatment plan of NWB while casted for months if Charcot foot was found. Pt instructed to keep routine appt. c PCP 4 days later.
Page 1 and 2: Clinical Presentation of Acute Char
Page 3 and 4: disease Etiology of Charcot joint d
Page 5 and 6: Clinical signs and symptoms of Char
Page 7 and 8: Joints affected 1)Tarsometatarsal j
Page 9 and 10: ‘Normal’ foot radiographs: Late
Page 11 and 12: Charcot foot: Loss of arch and acqu
Page 13: These are the X-ray X films of the
Page 18 and 19: Charcot treatment plan • Recogniz
Page 20 and 21: Cam/fracture walker
Page 22 and 23: CROW (Charcot Restraint Orthotic Wa
Page 26 and 27: Case #1 Initial films: Ankle and ch
Page 28 and 29: Case #1: AP View: Healing 2 nd meta
Page 30 and 31: Case #1: Lateral view: TMT joint de
Page 32 and 33: Case #2 72 y/o female already going
Page 34 and 35: Case #2: Lateral view of L foot.
Page 36 and 37: Case#2 R foot AP and Oblique views
Page 38 and 39: Case #2: Radiographic findings R fo
Page 40 and 41: Case #3 46 y/o male already under c
Page 42 and 43: Case #3: L foot Oblique view
Page 44 and 45: Case #3: Radiographic Findings “Q
Page 46 and 47: Case #4 Case #4 61 y/o male had bee
Page 48 and 49: Case #4: R ankle films
Page 50 and 51: Case #4: R foot AP view
Page 52 and 53: Case #4 Radiographic findings “Di
Page 54: Case #5 60 y/o female c PMH of bein
Page 58 and 59: Case #5 Pt called PT 6 days prior t
Page 60 and 61: Case #5: PT evaluation Girth measur
Page 62 and 63: Case #5: R foot lateral radiograph
Page 64 and 65: Case #5: R ankle radiographs
Page 66 and 67: Case #5: Ankle radiographic finding
Page 68 and 69: Case #5: external fixation
Page 70 and 71: Case #5: Rx Infection in R leg desp
Page 72 and 73: Case #6: L foot AP/oblique views
Page 74 and 75:
Case #6: R foot AP/oblique views
Page 76 and 77:
Case #6: Radiographic findings “M
Page 78 and 79:
Clinical signs and symptoms of Char
Page 80:
Treatment progression (podiatry)
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Acute Clinical Presentation of Charcot Arthropathy

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