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September 15, 1969, Vol 209, No. 11 >
ARTICLE | September 15, 1969

Multiple Neuropathic Joints, Including the Wrist, in a Patient With Diabetes Mellitus

Marvin J. Feldman; Kenneth L. Becker, MD; William E. Reefe, MD; Antonio Longo, MD
JAMA. 1969;209(11):1690-1692. doi:10.1001/jama.1969.03160240046009.
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A patient with long-standing diabetes and associated peripheral neuropathy with autonomic dysfunction had neuropathic arthropathy (Charcot's joint) involving both feet, the left ankle, the right knee, and the left wrist. In spite of considerable deformity and extensive roentgenographic evidence of damage to these joints, there was only minimal pain. Roentgenograms of the left wrist revealed narrowing of the joint spaces between the carpal bones, with fragmentation and disorganization. An open biopsy demonstrated eroded articular cartilage, a normalappearing synovial membrane, and an absence of an inflammatory cellular infiltrate. This appears to be the first case, to our knowledge, of diabetic arthropathy in which the upper extremity was affected.

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