Charcot Neuroarthropathy of the Foot and Ankle in the Acute Setting: An Illustrative Case Report and Targeted Review.

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Charcot neuroarthropathy (CN) is a rare but serious sequela of diabetes and other diseases that cause peripheral neuropathy. It is most commonly characterized by degeneration of the foot and/or ankle joints leading to progressive deformity and altered weight-bearing. If left untreated, the deformities of CN lead to ulceration, infection, amputation, and even death. Because of the associated peripheral neuropathy and proprioception deficits that accompany CN, patients typically do not perceive the onset of joint destruction. Moreover, in the hands of the untrained clinician, the initial presentation of CN can easily be mistaken for infection, osteoarthritis, gout, or inflammatory arthropathy. Misdiagnosis can lead to the aforementioned serious sequelae of CN. Thus, an early accurate diagnosis and off-loading of the involved extremity, followed by prompt referral to a specialist trained in the care of CN are crucial to prevent the late-term sequelae of the disease. The purpose of this article was to create an opportunity for enhanced understanding between orthopedic surgeons and emergency physicians, to improve patient care through the optimization of diagnosis and early management of CN in the emergent setting.





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Bagheri, Kian, Albert T Anastasio, Alexandra Krez, Lauren Siewny and Samuel B Adams (2023). Charcot Neuroarthropathy of the Foot and Ankle in the Acute Setting: An Illustrative Case Report and Targeted Review. The western journal of emergency medicine, 24(5). pp. 921–930. 10.5811/westjem.59833 Retrieved from

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Lauren Elizabeth Siewny

Assistant Professor of Emergency Medicine

Lauren E. Siewny, MD, FACEP is an Assistant Professor in the Department of Emergency Medicine at the Duke University School of Medicine and a board-certified Emergency Physician. A graduate of the Wright State University Boonshoft School of Medicine, she completed her training in Emergency Medicine at Duke University Hospital, where she served as Chief Resident and continues to work clinically as a board-certified Emergency Physician. Administratively, as Medical Director of the Duke University Hospital Emergency Department, her areas of interest include ED utilization management, complex care management, and advanced health analytics. Academically, Dr. Siewny is an NIH-funded and published researcher whose work focuses on using implementation science to identify and address barriers to quality care in sickle cell disease. Dr. Siewny has also taught medical student, graduate medical education, and continuing medical education courses for the past ten years and mentored both undergraduate and graduate students. These efforts have been recognized with several teaching, academic achievement, and service leadership awards.


Samuel Bruce Adams

Associate Professor of Orthopaedic Surgery

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