Severe destructive arthropathy caused by impaired joint sensation. Diabetes mellitus, tabes dorsalis, and syringomyelia are common causes. The foot is involved most commonly. Clinical Features Pain after joint use progressing to pain with minimal movement and at rest and at night. As opposed to RA, there is generally no early morning stiffness or gelling.
Patients often have pain on passive movement with crepitus and joint enlargement.
May develop genu valgus or varus deformity at knee if there is a disproportionate loss of cartilage on one side. Pseudolaxity of collateral ligaments develops with degeneration of cartilage. Radiographic Features Characteristic progressive changes include joint-space narrowing, subchondral osteosclerosis, marginal osteophyte formation, and subchondral cysts. Treatment Goal of treatment. Relieve pain, preserve joint motion and function, and prevent further injury and wear of cartilage.