WWWTP #11 Answer…

October 10, 2013

WWWTP


Middle-aged diabetic woman with bilateral foot swelling:

WWWTP 11.1 WWWTP 11 WWWTP 11.3 WWWTP 11.2

This patient has extensive destruction, debris, dislocation, disorganization, and increased density of both midfeet, consistent with neuropathic foot.  Likely from years of poorly controlled diabetes.  Clinically this made sense because she did not have pain or sensation in a stocking-distribution below the knees.  She had good pulses and no overt signs of infection (on the differential is osteomyelitis causing significant bony destruction). 

For more info on neuropathic foot:

Charcot Changes in the Midfoot

Author:  Russell Jones, MD

References

1.  Charcot Changes in the Diabetic Foot and Ankle.  Wheeless’ Textbook of Orthopaedics.  http://www.wheelessonline.com/ortho/charcot_changes_in_the_diabetic_foot_and_ankle Accessed 10/2013.

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EMREMS: Radiology in Emergency Medicine

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