Charcot arthropathy - Diagnosis

Laboratory Tests-Leukocytes help differentiate between Charcot arthropathy and osteomyelitis, white cells are elevated when infection is presentErythrocyte-sedimentation rate is used to help differentiate between Charcot arthropathy and osteomyelitis and infection is high in-Basic metabolic profile is useful to identify the etiology, creatinine, urea nitrogen suggesting high renal disease, while high glucose suggests diabetesGlycated hemoglobin, indicating control of hyperglycemia in diabetics, hyperglycemia determine nonenzimatica glycosylation of collagen and joint laxity with unstable ligementelor-Level of alkaline phosphatase, calcium, phosphorus and parathyroid hormone help to identify bone disease, Paget's diseaseBone metastases, hypercalcaemia indicatesDeficiency of folate and B12 suggest etiology of peripheral neuropathy or chronic alcoholism-Tests and coagulation abnormalities in liver function may suggest alcoholismPlasma-evaluation reaginei help diagnose syphilis
Imaging Studies:Plain radiograph help staging the disease, determine the presence of active disease or stable joint and to identify osteopenia, periarticular bone fragmentation, subluxatiilor, dislocation, and destruction fracutirlor generalized. The radiographic evidence suggestive of ages submitted include subchondral sclerosis, osteophytosis, soft tissue swelling and subluxation.Duration of neuropathy is characterized by considerable disruption of articular cartilage and bone debris in synovium-dendritic synovitis.
Bone scan helps to differentiate between Charcot arthropathy and osteomyelitis. Scanning with indium 111 is more specific than the tehnetiu 99. Leukocyte scan is used to help confirm the diagnosis of osteomyelitis.Allows magnetic resonance imaging anatomy of the area and help differentiate between osteomyelitis and Charcot arthropathy.Doppler ultrasound is used to exclude deep venous thrombosis.
Other tests include:Lumbar puncture to exclude syphilisBone-biopsy to exclude osteomyelitis-Portable Infrared thermometers measure skin temperature and dermal inflammation active monitorsExclude septic joint-joint aspirationSynovial biopsy-detected fragments of bone and cartilage in joint destruction.The differential diagnosis is made with the following conditions: storage diseases of calcium phosphate, primary osteoarthritis, osteonecrosis, posttraumatic osteoarthritis, infection, alcaptonuria.