Charcot神经病性关节病是一种相对罕见的,导致关节破坏和降低患者生活质量的慢性疾病。Charcot关节病的早期诊断对于良好的预后至关重要。然而,诊断通常基于临床病程,需要对患者进行纵向随访.在具有暗示性症状和潜在病因的患者中怀疑Charcot关节病。脊柱手术失败不是Charcot关节病的已知原因。在此,我们报告了一名脊柱手术失败后发展为踝关节Charcot神经病性关节病的患者。一名58岁的男子因左脚踝疼痛肿胀2周而出现在急诊室,并自发发展。他8年前接受了与神经损伤有关的脊柱手术,导致脚趾伸展和脚踝背屈的弱点,和膝盖以下的感觉丧失。CT和T2加权矢状位MRI显示有细微的糜烂性病变,半脱位,硬化症,碎片化,和巨大的骨缺损。根据病人的病史和放射学检查结果,诊断为Charcot关节病。然而,异常的血液参数,血培养阳性,尽管感觉下降,但剧烈的疼痛提示诊断为脓毒性关节炎。因此,进行诊断性关节镜检查.初次手术后,踝关节表现出持续的破坏。因此,在接下来的2年内进行了多次重复手术.尽管早期诊断和治疗Charcot关节病,踝关节的破坏仍在继续。鉴于Charcot关节病的慢性病程和不良预后,对于神经病变患者,必须考虑这种诊断。
Charcot neuropathic arthropathy is a relatively rare, chronic disease that leads to joint destruction and reduced quality of life of patients. Early diagnosis of Charcot arthropathy is essential for a good outcome. However, the diagnosis is often based on the clinical course and longitudinal follow-up of patients is required. Charcot arthropathy is suspected in patients with suggestive symptoms and an underlying etiology. Failed spinal surgery is not a known cause of Charcot arthropathy. Herein we report a patient with ankle Charcot neuropathic arthropathy that developed after failed spinal surgery. A 58-year-old man presented to the emergency room due to painful swelling of the left ankle for 2 weeks that developed spontaneously. He underwent spinal surgery 8 years ago that was associated with nerve damage, which led to weakness of great toe extension and ankle dorsiflexion, and sensory loss below the knee. CT and T2-weighted sagittal MRI showed a fine erosive lesion, subluxation, sclerosis, fragmentation, and large bone defects. Based on the patient\'s history and radiological findings, Charcot arthropathy was diagnosed. However, the abnormal blood parameters, positive blood cultures, and severe pain despite the decreased sensation suggested a diagnosis of septic arthritis. Therefore, diagnostic arthroscopy was performed. The ankle joint exhibited continued destruction after the initial surgery. Consequently, several repeat surgeries were performed over the next 2 years. Despite the early diagnosis and treatment of Charcot arthropathy, the destruction of the ankle joint continued. Given the chronic disease course and poor prognosis of Charcot arthropathy, it is essential to consider this diagnosis in patients with neuropathy.