Charcot Arthropathy : Mnemonics

Mnemonic: 10 S

1. Sugar (diabetes) - most commonly foot and ankle
2. Syringomyelia - 80% in shoulder and elbow
3. Spinal cord injury - hip, knee, ankle and spine
4. Spastic paraplegia
5. Syphilis - most commonly knee
6. Spirits (alcohol)
7. Subacute combined degeneration
8. Steroids
9. Scaly disease (leprosy) - 2nd most common cause in upper extremity
10. Scleroderma

3 Theories of Charcot Arthropathy

a. Neuro-traumatic: Damage to sensory feedback → Repeated microtrauma → Release of proinflammatory cytokines → Bone resorption

b. Neuro-vascular: Change in vascularity caused by dysregulation of vasomotor and trophic nerve supply

c. Neuro-inflammatory: Abnormal persistence of inflammatory response and inability to terminate inflammatory response

Classic features

Mnemonic: 6 Ds

1. Destruction
2. Disorganization
3. Debris (loose bodies)
4. Density (sclerosis)
5. Distension (joint effusion)
6. Dislocation (dislocation/subluxation)

Eichenholz classification

Mnemonic: CDCR or IFCC

1. Clinical (Inflammatory) - Demineralization
2. Dissolution (Fragmentation) - Debris and Dislocation
3. Coalescence - Debris absorption and Density increase
4. Resolution (Consolidation) - Deformity

Mnemonic: ABCDEF

1. Activity limitation
2. Bracing or Casting (Total contact cast)
3. Discontinue when skin temperature normal
4. Evade total joint arthroplasty
5. Fusion after inflammatory phase in feet

0 - Clinical

Limited weight bearing (possibly TCC or PPWB), close observation

1 - Fragmentation

TCC, limited weight bearing

2 - Coalescence

TCC followed by CROW

3 - Reparative

Possible surgical intervention for removal of bony prominences associated with ulceration