musculoskeletal and connective tissue disorders
Neurogenic Arthropathy
Key Points
Neurogenic arthropathy is a rapidly destructive arthropathy that occurs when perception of pain and position sense are impaired (eg, due to diabetes or stroke). Joint destruction out of proportion to pain is typical, often with rapid progression to joint disorganization in advanced stages. Confirm the diagnosis with x-ray evidence of joint destruction (initially similar to changes seen in osteoarthritis) out of proportion to pain in patients with a predisposing neurologic disorder. Treat the cause when possible and protect the joint from further injury by physical means (eg, by stabilization). Refer patients for surgery when appropriate. 