Neurogenic Arthropathy
Neurogenic arthropathy also called is Charcot's joint. Charcot's joint massive destruction of a stress-bearing joint, with development of large flanges and spurs of new bone at the sides of the joint. The condition eventually causes inability to use the joint but is accompanied by little or no sensation of pain or discomfort. The disorder accompanies damage to the nervous system in which sensory knowledge of joint position and strength is lost; the affected individual is not aware of overuse or injury so that destructive changes can develop quickly. The most common cause of Charcot's joint is tabes dorsalis , a form of nervous system disease that occurs in untreated tertiary venereal syphilis; the knee, hip, ankle, and lower back are most often affected. Neurogenic arthropathy of the foot occurs as a complication of diabetes. Other diseases that destroy the sense of joint position or of pain may also cause Charcot's joint, such as leprosy, spinal cord injury, or pernicious anemia. Neurogenic arthropathy of the hip can cause insidious articular destruction. Neurogenic arthropathy is a rapidly destructive arthropathy due to impaired pain perception and position sense, which can result from various underlying disorders, most commonly diabetes and stroke.
Common manifestations include joint swelling, effusion, deformity, and instability. Pain may be disproportionately mild due to the underlying neuropathy. Degenerative spinal disease with nerve root compression it is conditions that predispose to neurogenic arthropathy. Impaired deep pain sensation or proprioception affects the joint's normal protective reflexes, often allowing trauma and small periarticular fractures to pass unrecognized. Increased bone blood flow from reflex vasodilation, resulting in active bone resorption, contributes to bone and joint damage.Each new injury sustained by the joint causes more distortion as it heals. Hemorrhagic joint effusions and multiple small fractures can occur, accelerating disease progression. Ligamentous laxity, muscular hypotonia, and rapid destruction of joint cartilage are common, predisposing to joint dislocations, which also accelerate disease progression. Advanced neurogenic arthropathy can cause hypertrophic changes, destructive changes, or both.
Causes of Neurogenic Arthropathy
Common causes of Neurogenic Arthropathy
- Rapid joint destruction.
- Tabes dorsalis.
- Fractures.
- Bony healing.
Symptoms of Neurogenic Arthropathy
Common symptoms of Neurogenic Arthropathy
- Pain.
- Swollen.
- Synovial effusion.
- Fever.
- Malaise.
Treatment of Neurogenic Arthropathy
Common Treatment of Neurogenic Arthropathy
- Treatment of the underlying neurologic condition may slow progression of the arthropathy and, if joint destruction is still in the early stages, partially reverse the process.
- Neurogenic arthropathy is not expected to be progressive, good results can be obtained with total hip and knee replacements. However, loosening and dislocation of the prosthesis are major hazards
- Asymptomatic or minimally symptomatic fractures facilitates early treatment; immobilization (with splints, special boots, or calipers) protects the joint from further injury, possibly stopping disease evolution.
|
