Role of MRI Spine in Evaluation of Cases of Neurotrophic Arthropathy

Abstract

Introduction: A neurotrophic joint (also known as a Charcot joint) refers to a progressive degenerative/ destructive joint disorder in patients with abnormal pain sensation and proprioception. A substantial number of neurotrophic joints are caused secondary to lesions of the spine. Many a times the patient does not give any history indicating a spine lesion. Hence MRI scan of Spine should be made a part of the investigations in every case of neurotrophic joint. Aims and objectives: To study the incidence of Spinal lesions as a primary causative factor behind a neurotrophic joint and to study the efficacy of MRI spine exam in correctly diagnosing Spinal lesions in patients presenting with a neurotrophic joint. Materials and methods: This study was conducted in the Radiology department of Dhiraj general Hospital. 20 patients presenting with neurotrophic joint/joints but giving no history suggestive of an underlying spinal pathology were evaluated by MRI spine. Results: Out of 20 patients presenting with neurotrophic joint who were evaluated by MRI spine, only 12 scans revealed a spinal pathology secondary to which the patient had developed neuropathic change of the affected joint. Conclusion: Onset of joint neuropathy is usually insidious. If this pathological process continues unchecked, it can result in joint deformity, ulceration and/or super infection, loss of function, and in the worst-case scenario, amputation or death. Early identification of joint changes is the best way to limit morbidity and for that early diagnosis of any underlying pathology is important. MRI spine is a sensitive tool to detect any lesion of the spine. It helps to accurately diagnose a variety of spinal lesions and tells about its exact size, extent and severity and thereby contributes immensely in the management of a neurotrophic joint.