This is in response to a recent practice aticle in CMAJ.1 Although infection and gout are likely diagnoses in this presentation, Charcot arthropathy needs to be high up on the differential diagnosis list — particularly when a patient has diabetes.1 The presence of pain is not sufficient to rule out this rapidly deforming disease, and early imaging may not detect the developing process. Prompt intervention (non-weight bearing) can prevent life-altering disfigurement. As a podiatrist, I often see patients with Charcot arthropathy only after the foot has collapsed — early foot protection could have protected their mobility.
Footnotes
Competing interests: None declared.