Neurogenic arthropathy results from an underlying disorder that affects the nerves, such as diabetes and stroke.
People develop neurogenic arthropathy because they cannot feel injuries that damage their joints.
Typical symptoms include stiffness, fluid, and pain in the joints.
The diagnosis is based on x-rays.
Treatment of the underlying nerve disorder and stabilization of joints and fractures, and sometimes surgery, can help slow disease progression and reduce pain.
Any joint can be affected depending on where the nerve damage is located. The most commonly affected joints are
The knee and ankle
In people who have diabetes, the joints in the foot
Often, only one area is affected, such as the foot and ankle, and usually not more than two or three joints.
Causes of Neurogenic Arthropathy
When certain nerves are damaged, people may become unable to sense pain. A variety of disorders, such as diabetes mellitus, spinal cord disorders (such as injuries and fluid-filled cavities in the spinal cord [ syringomyelia Syrinx of the Spinal Cord or Brain Stem A syrinx is a fluid-filled cavity that develops in the spinal cord (called syringomyelia), in the brain stem (called syringobulbia), or in both. Syrinxes may be present at birth or develop later... read more ]), and syphilis Syphilis Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. It can occur in three stages of symptoms, separated by periods of apparent good health. Syphilis... read more , can damage these nerves. The most common causes are
People with nerve damage may injure a joint many times without noticing. Injuries may occur for years with accumulated joint damage before the joint malfunctions. However, once it malfunctions, the joint may be permanently destroyed within a few months.
Symptoms of Neurogenic Arthropathy
In its early stages, neurogenic arthropathy appears similar to osteoarthritis Symptoms Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function. Arthritis due to damage of joint... read more because the joints are stiff and fluid may accumulate in them. Pain is a common early symptom. However, because the ability to sense pain is commonly impaired, the degree of pain is often unexpectedly mild considering the amount of joint damage. Despite this, if the disorder progresses rapidly, the joint can become extremely painful. In these cases, the joint is usually swollen because of excess fluid and abnormal bone growth. It may look deformed because it has been fractured and ligaments have stretched, allowing loose pieces of bone and cartilage to slip out of place. Moving the joint may cause a coarse, grating sound because of bone fragments floating in the joint.
Different joints are affected by different underlying disorders. For example, complications of untreated syphilis Syphilis Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. It can occur in three stages of symptoms, separated by periods of apparent good health. Syphilis... read more affect the knee and hip, and diabetes mellitus Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Urination and thirst are... read more affects the foot and ankle. Syringomyelia commonly affects the cervical (neck) spine and thus the upper limb joints, especially the elbow and shoulder.
People rarely develop a second arthritis that is caused by bacteria (see Infectious Arthritis Infectious Arthritis Infectious arthritis is infection in the fluid and tissues of a joint usually caused by bacteria but occasionally by viruses or fungi. Bacteria, viruses, or fungi may spread through the bloodstream... read more ) and may or may not have the fever or general feeling of illness (malaise) that typically occurs with infectious arthritis. Infectious arthritis is particularly likely in people with diabetes.
Structures such as blood vessels, nerves, and the spinal cord can become compressed because of bony overgrowth.
Diagnosis of Neurogenic Arthropathy
Doctors suspect neurogenic arthropathy when people have a disorder that affects the nerves and have typical symptoms of joint problems.
X-rays Plain X-Rays X-rays are high-energy radiation waves that can penetrate most substances (to varying degrees). In very low doses, x-rays are used to produce images that help doctors diagnose disease. In high... read more can detect joint damage, which often includes calcium deposits and abnormal bone growth, and deformities.
Prevention of Neurogenic Arthropathy
Avoiding injuries and using protective wear, such as splints or special boots
Sometimes neurogenic arthropathy can be prevented by taking care of the feet and by avoiding injuries.
Splints or special boots can sometimes help protect vulnerable joints. Stabilizing the joints may prevent neurogenic arthropathy in a person at risk.
Treatment of Neurogenic Arthropathy
Treatment of the underlying nerve disorder
Surgery to repair or replace joints
Treatment of the underlying nerve disorder can sometimes slow or even reverse joint damage. Stabilizing painless fractures and splinting unstable joints can help stop or minimize the damage.
Hip and knee joints may be surgically repaired or replaced. However, artificial joints often loosen and dislocate prematurely.