Missing the boat: fatal ending to a missed case of Charcot arthropathy. (16th June 2020)

• Record Type: Journal Article
• Authors: Galeazzi Rech, Anna Luiza; Stüve, Yvon; Toepfer, Andreas; Schimke, Katrin E
• Is Part Of: Endocrinology, diabetes & metabolism case reports. (2020)
• Publication Date: 2020-06-16
• Subjects: Geriatric -- Male -- White -- Switzerland; Bone -- Bone -- Insulin -- Charcot neuropathic osteopathy* -- Diabetes mellitus type 2 -- Diabetic foot syndrome; Leg pain -- Feet - pain -- Feet - increased size -- Erythema -- Hyperthermia -- Oedema -- Pallanaesthesia* -- Nephropathy -- Ankle brachial index* -- Monofilament test* -- C-reactive protein -- White blood cell count -- Haemoglobin A1c -- Estimated glomerular filtration rate -- Skin biopsy -- MRI -- X-ray -- Brain natriuretic peptide -- Angiography -- Angioplasty -- Amputation -- Amoxicillin -- Clavulanic acid* -- Piperacillin* -- Tazobactam* -- Diuretics -- Cefazolin*; Geriatrics -- Podiatry -- Radiology/Rheumatology; Error in diagnosis/pitfalls and caveats -- June -- 2020; Endocrinology -- Periodicals; Diabetes -- Periodicals; Diabetes Mellitus; Endocrinology; Diabetes; Endocrinology; Case Reports; Periodicals; Periodicals; 616.4
• DOI: 10.1530/EDM-20-0013
• Languages: English
• ISSNs: 2052-0573

Abstract

Abstract : Summary: Acute Charcot neuropathic osteoarthropathy (CN) is a clinical entity which can easily go unrecognized in its acute early stages due to lack of awareness and unspecific presentation. However, missing early diagnosis can lead to severe complications. We present the case of a 72-year-old male patient who went through the natural course of the disease unnoticed before the very eyes of his physicians leading to a tragic end. We aim to raise awareness for this rare diabetic complication, emphasizing the necessity of early diagnosis and adequate, interdisciplinary treatment. Learning points: Clinical signs and symptoms of acute Charcot neuropathic osteoarthropathy (CN). Red flags. Importance of early diagnosis and correct treatment. Diagnostic challenges of acute CN. Awareness of high morbidity and mortality.