Lodewijk Jules van Holsbeeck MD, Presenter: Nothing to Disclose

William B. Morrison MD, Abstract Co-Author: Consultant, General Electric Company Consultant, AprioMed AB Patent agreement, AprioMed AB Consultant, Zimmer Holdings, Inc

Viviane Khoury MD, Abstract Co-Author: Nothing to Disclose

Paula Gangopadhyay BS, Abstract Co-Author: Nothing to Disclose

To identify early findings of Charcot arthropathy on MR imaging.

The MR imaging reports database was searched for the words “Charcot” and "Neuropathic"; resultant patient list was reviewed for the following inclusion criteria: 1) documented early Charcot arthropathy by clinical exam; or 2) follow-up imaging showing evolution into classic Charcot arthropathy. Images were reviewed for location of Charcot, as well as marrow, articular, ligamentous, tendinous and soft tissue findings on the initial MR exam. Findings on follow-up were documented.

Results: Fifteen feet in fourteen patients were identified with MR imaging of early Charcot. Seven were located at the Lisfranc joint and eight at the Chopart joint. Initial findings included subchondral bone marrow edema in 10/15; subchondral fracture in 3/15; tear of a supporting ligament in 10/15; tendinopathy in 5/15; and muscle atrophy in 7/15. In cases of early Charcot at the Lisfranc joint, tearing of the inferior capsule of the first TMT joint was followed by midfoot collapse; in cases of early Charcot at the Chopart joint, tearing of the spring ligament was followed by hind foot collapse.

MRI can be successfully used to predict future risk for rapidly progressive arthropathy at both the Chopart and Lisfranc joints.

Identification of initial ligamentous injuries preceding Charcot arthropathy in the diabetic population could assist surgeons in early intervention and prevention of late deformity.

van Holsbeeck, L, Morrison, W, Khoury, V, Gangopadhyay, P, Early Findings of Charcot Arthropathy on MR Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045598.html