Is It Rheumatoid Arthritis … or Something Else?

When dealing with rheumatoid arthritis (RA), polyarthritis is seen (especially in the hands and wrists). However, neuropathic arthropathy (NA) is often seen as an RA mimicker. In an article from The Rheumatologist, authors explain a very rare but very real connection between RA and NA, which brings up the question: Does your patient really have RA? 

NA was first described in detail by the French neurologist Jean Marie Charcot in 1868. NA is also known as “Charcot joint” or “Charcot foot,” and is the progressive degeneration of a weight bearing joint. This often leads to deformity due to loss of sensation. According to the article, two types of Charcot arthropathy have been described: 

Good review of Neuropathic Arthropathy – not common, but I've picked up a couple of these https://t.co/BkxWivR7BZ

— Paul Sufka, MD (@psufka) August 12, 2018

https://twitter.com/RajkiranDudam/status/1028835385139376128

NA was first described in detail by the French neurologist Jean Marie Charcot in 1868. NA is also known as “Charcot joint” or “Charcot foot,” and is the progressive degeneration of a weight bearing joint. This often leads to deformity due to loss of sensation. According to the article, two types of Charcot arthropathy have been described: 

The atrophic form: This is marked by osteopenia, destruction (i.e., the disappearance of bone substance), and dislocation. 

The hypertrophic variety: This usually presents with upper motor neuron lesions and is less common than the atrophic form. According to the article, it is marked by osteosclerosis and osteophytes, bone fragmentation, and absence of osteopenia. 

https://twitter.com/savageeimear/status/1028956245837791233

When it comes to NA, the most common diseases that are connected are diabetes, syphilis, leprosy, and syringomyelia. To better explain the possibility of NA being an RA mimicker, the authors also provide cases to show the importance of vigilance when treating these patients with supposed RA. 

For more about rheumatoid arthritis, check out an article on how flu vaccines might reduce mortality in patients with rheumatoid arthritis.  

SOURCE: The Rheumatologist