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An unusual clinical presentation of acute Charcot neuroarthropathy

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An unusual clinical presentation of acute Charcot neuroarthropathy

25 February 2020

Diabetic Charcot neuroarthropathy (CN) is an uncommon foot complication but it needs to be recognised and managed as early as possible to help prevent gross deformity. In its acute stage, it is typically characterised as being red/pink, swollen, very warm, and may have some deformity and possibly some pain. However, one of the overarching features of all CN is a loss of sensation and evidence of autonomic nerve dysfunction. The case is unusual because although the clinical features of an acute CN were present, the bedside tests commonly used for determining sensory neuropathy were absent. When further laboratory neurological function tests were performed, small and large fibre neuropathy was evident. This highlights the need for clinical vigilance when diagnosing acute CN.

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