134 Charcot’s joint
Salient features
Examination
• Enlargement of the affected joint (compare with the other side)
• Instability of the joint, in particular hypermobility of the joint
• May be warm, swollen and tender in the early stages
• Enlargement and crepitus may be present in the later stages
• Collapse of the longitudinal arch resulting in a rocker-bottom deformity.
• Check sensation in the affected limb
• Tell the examiner that you would like to investigate as follows:
• Do a thorough neurological examination, looking for loss of proprioception, and/or pain sensation, and vibratory sensation with a 128 Hz tuning fork
• Ask for lancinating pains, check posterior column signs and look for Argyll Robertson pupil (tabes dorsalis)
