Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Neurogenic Arthropathy

(Charcot Joints; Charcot's Joints; Neuropathic Arthropathy)


Kinanah Yaseen

, MD, Cleveland Clinic

Reviewed/Revised Dec 2022

Neurogenic arthropathy is caused by progressive joint destruction, often very rapid, that develops because people cannot sense pain, continually injure joints, and thus are not aware of the early signs of joint damage.

  • 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

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 Symptoms 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.

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

  • X-rays

Doctors suspect neurogenic arthropathy when people have a disorder that affects the nerves and have typical symptoms of joint problems.

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.

quiz link

Test your knowledge

Take a Quiz!