Introduction

Charcot’s Joints is a progressive degenerative disease of the joints. Caused by nerve damage, it results in the instability of the joint and loss of ability to feel pain in the joint. It begins with swelling, warmth, increased mobility, and instability in a single joint or many joints. It can progress into deformity.

Causes

Charcot’s Joints results from nerve damage that impairs a person’s ability to perceive pain coming from a joint. Repeated minor injuries and fractures go unnoticed until the accumulated damage permanently destroys the joint.

A variety of injuries, diseases, and conditions such as diabetes, spinal disease, and syphilis can damage the nerves supplying sensation to the joints.

Symptoms

It may be many years before enough damage occurs to cause joint dysfunction and symptoms. After symptoms develop, however, the disease can progress so rapidly that the joint is destroyed within a few months.

In its early stages, Charcot’s Joints is often confused with osteoarthritis. Stiffness and fluid in the joint are common. Usually, the joint isn’t painful or is less painful than would be expected considering the amount of joint damage. However, if the disease progresses rapidly, the joint can become extremely painful. In these cases, the joint is usually swollen from excess fluid and new bony growths. It is often deformed because repeated fractures and stretching of ligaments allowing it to slip out of place. Bone fragments may float around in the joint, causing a coarse, grating sound when the joint is moved.

Although the knee is most often affected, this disease can develop in almost any joint. The foot is most commonly affected in people who have diabetes. The joints affected—frequently only one and usually not more than two or three—depend on the location of the nerve damage.

Treatment

Treatment of the underlying neurological disease can slow or even reverse joint destruction. Diagnosing and immobilizing painless fractures and splinting unstable joints can help stop or minimize joint damage. Hips and knees may be surgically replaced if the neurological disease isn’t progressing, but artificial joints often loosen prematurely.

In the early stages of Charcot’s Joints, braces to stabilize the joints can help stop or minimize the damage. When the disease has progressed beyond braces, surgery can sometimes repair the joint. If the damage is extensive, an artificial joint may be necessary.