Pathophysiology: Repetitive bone & joint trauma due to impaired sensation/ proprioception

Causes
Diabetes mellitus (most common)
Posterior column disease (eg, B12 deficiency, tabes dorsalis)

Signs / symptoms:
Acute
Inflammatory erythema, warmth & edema of the foot
Minimal bone involvement (x-rays often normal)
Chronic
Bone deformities (eg, subluxation, collapsed arch, stress fracture)
Neuropathic ulcers, cellulitis, osteomyelitis

Treatment / management:
Acute: Foot cast to reduce edema & offload weight bearing
Chronic: Orthotic footwear, infection management, surgical realignment

свернуть