Mr.W, 53 years old, is seen in the clinic with concerns about his left foot.He has a 40-year history of type 1 diabetes with "fairly good" control on twice-daily insulin.He denies injury but states that he tripped a few months ago and that his foot is sore when he walks.Physical examination reveals an edematous, erythremic, and warm foot.There is a superficial ulcer on the plantar surface.Which of the following is the most likely diagnosis?

Question

Quizplus · Accepted Answer

The presentation described is consistent with a Charcot joint, also known as neuropathic arthropathy, which is a serious complication of diabetes. It can result from repeated micro-trauma and stress fractures due to underlying neuropathy, leading to degeneration of joint structures and destruction of bone. The edema, erythrema, warmth, and ulceration are classic findings. Fallen arch, arthritis, and sprained ankle are less likely given the clinical presentation and history provided.

MrW, 53 Years Old, Is Seen in the Clinic with Concerns