Clin Osteol 2024; 29(4): 147-150

Charcot's osteoarthropathy or Sudeck's Syndrome? A case reportCase reports

Novák Vladimír^1,2

¹ Interní oddělení, kostní, diabetologická a endokrinologická ambulance, Klatovská nemocnice a. s., Klatovy

² Interní, diabetologická a endokrinologická ambulance, Nemocnice Vimperk, Vimperk

A patient (born in 1950), was examined for suspicion of Sudeck's syndrome of the left foot. The problems arose after prolonged work in the garden -⁠ significant pain in the instep and sole, sensitivity to touch, swelling and redness up to the ankles. There was no previous fracture or other trauma, in the pre-illness the patient was fully mobile without support. Due to the sixteen-year history of type 2 diabetes mellitus, we considered Charcot's osteoarthro­pathy in the differential diagnosis; Subsequently, three-phase skeletal scintigraphy and MRI of the left foot were compatible with this diagnosis, as they showed pathologically increased activity in the area of the instep of the left foot, respectively osteolytic destruction of the intermediate cuneiform bone. During treatment, the patient refused to relieve the left foot, the treatment was therefore only medicamentous. After 2 years from the onset of the sym­ptoms, the patient is without signs of inflammatory activity, the left foot is without swelling, but with a violation of the arch and a slight deformity. In the case report we did not come to a clear diagnostic conclusion: For Charcot's osteoarthropathy, hyperalgesia and allodynia are atypical, as was the case at the beginning of the problem, as well it was not possible to assess the effect of relieving the limb on the patient's difficulties or on changes in MRI. We do not rule out a combination of both syndromes.

Keywords: complex regional pain syndrome; Charcot's osteoarthropathy; Sudeck's syndrome; type 2 diabetes mellitus

Published: December 11, 2024  Show citation