Gout as a trigger for acute charcot neuro-osteoarthropathy?

Abstract

Patients with diabetes and a painful, hot, swollen foot can sometimes present a diagnostic challenge. Gout can often present in a similar fashion to diabetic foot infections or acute Charcot neuro-osteoarthropathy, and cases have been described where patients with Charcot neuro-osteoarthropathy were misdiagnosed as having gout, leading to treatment delay. We describe a patient who presented with a painful, swollen, warm foot who did not respond to initial treatment with antibiotics. Improvement in his symptoms occurred following treatment for gout, however he then went on to develop Charcot neuroosteoarthropathy. As far as we are aware, this is the first case described in the literature where acute gout may have triggered acute Charcot neuro-osteoarthropathy. It is important to bear in mind that more than one pathology may be present in a patient at the same time or may closely follow one another.