Neuropathic Osteoarthropathy 169

J. Kramer and A. Scheurecker


9    Neuropathic Osteoarthropathy



Definition


Neuropathic osteoarthropathy refers to massively destructive atrophic/hypertrophic joint disease of neurogenic origin.


Pathology


Image  exact cause unknown (proprioceptor impairment?)


Image  mechanical and vascular factors contribute equally to subsequent disintegration of the knee joint


Image  neurotraumatic causes of vascular changes lead to productive and resorptive joint changes


Image  increased vulnerability of bone to normal and increased mechanical stresses


Etiology


Image  tabes dorsalis


Image  amyloidosis


Image  congenital form


Image  knee joint extremely rarely involved in:



–   syringomyelia


–   diabetes mellitus


–   alcoholism


–   meningomyelocele


–   idiopathic form


Clinical Signs


Image  joint swelling


Image  hypermobility of the joint


Image  uncharacteristic pain symptoms ranging from none to massive pain


Image  depending on underlying disease


Diagnostic Evaluation


Image (→ method of choice)


Recommended Radiography Projections


Image  anteroposterior (AP)


Image  lateral


Findings (Fig. 9.1)


Image  marked sclerosis


Image  articular destruction


Image  fragmentation

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Jan 17, 2016 | Posted by in MUSCULOSKELETAL IMAGING | Comments Off on Neuropathic Osteoarthropathy 169

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