Charcot’s joint is a joint lesion caused by certain neurological diseases, also known as neurological arthritis. Common causes include spinal consumption and spinal cavitation. The primary neuropathy can cause deep sensory deficits in the joints, and the patient is unable to detect shock, wear and tear, compression, or strain on the joints, and therefore cannot protect and avoid them voluntarily. The destruction of the joint surface and the loss of bone fragments become free bodies in the joint. The joint is full and swollen, with internal bleeding and oozing. The early stage of the disease is painless and is not easily noticed by the patient, but is characterized by swelling, weakness, hypermobility and instability. The most important features of the disease are swollen, painless joints with an abnormal range of motion, extensive destruction, sclerosis or odd forms of the bony ends of the joints, bone redundancy, irregularity or widening of the joint space, calcification of the surrounding soft tissues, intra-articular free bodies and bone fragments. The diagnosis can be confirmed by the combination of radiographs and clinical symptoms, as well as the presence of primary neurological disease. Treatment of this disease should begin with active treatment of the primary neurological disease. In the acute phase of treatment, rest should be taken to avoid joint trauma and shock, and a brace should be used as early as possible to stabilize and protect the joint to prevent the development of deformity and bone end destruction. Excessive standing, walking, jumping and weight-bearing should be avoided. Special attention should be paid to the prevention and control of infection, as it is difficult to control and many patients suffer from amputation as a result. Depending on the condition, hot compresses, physiotherapy, Chinese herbal fumigation, acupuncture and Chinese herbal medicine can be used to certain effect. Disease Overview Charcot first described neuropathic arthropathy in 1868, so it is also called charcot arthropathy. These diseases are caused by the absence of pain, and are also known as painless arthropathy. It is common between 40 and 60 years of age, male:female = 3:1. Etiology It can occur in the central nervous system syphilis, spinal cord cavitation, diabetic neuropathy, spinal cord membrane bulge, congenital nociceptive deficiency, etc. In this case, the joints of shoulder, elbow, cervical spine, hip, knee, ankle and toe are damaged due to the absence of protective mechanisms for nociception leading to joint overuse and impingement. In addition, the pathogenesis of medically induced joint destruction by long-term application of corticosteroids (e.g., in the treatment of rheumatoid arthritis, systemic lupus erythematosus, and after organ transplantation) and painkillers (botaxone, anti-inflammatory pain) is in the same manner. Spinal cord cavitation of the cervical medulla is a common neuropathic disorder involving the joints of the upper extremities. The shoulder, elbow, cervical spine and wrist are the most commonly affected sites. Spinal cord cavitation is associated with joint destruction in the upper extremities in about 25% of cases. In addition to joint lesions, there is also unilateral or bilateral loss of temperature sensation, so that scalding scars are visible on the skin of the upper extremities. Spinal syphilis, also called spinal consumption, often involves the knee, hip, ankle and lumbar spine. In addition to bone and joint changes, motor ataxia, deep sensory disturbances in the lower extremities Arggll-Robertson pupils, positive serum Convair reaction are seen. Spinal cord bulging, ankle and small foot joint involvement is common. Painless ulcers on the soles of the feet, soft tissue masses seen in the lumbosacral region, skin depression or hirsutism, loss of sensation in lower limb atrophy, and dysfunction of the extensor muscles. In diabetic neuropathy, painless swelling of the small joints of the foot (tarsometatarsal, metatarsal, interphalangeal, etc.) may occur, etc. Clinical manifestations Neuropathic arthropathy joints are gradually swollen, unstable, fluid accumulation, and the joints may wear out blood-like fluid. Most of the swollen joints are painless or only slightly distended, and functional limitations of the joints are not obvious. Pain and functional limitation of the joint are not consistent with the swelling and destruction of the joint. In the late stage, further development of joint destruction may lead to pathological fracture or pathological joint dislocation. In the early stage, soft tissue swelling and dense bone ends are seen. In the late stage, the joint shows varying degrees of destruction, gap narrowing, dense bone ends, pathological fractures, intra-articular free bodies, bone resorption, degenerative bone redundancy and new bone formation, as well as joint dislocation and deformity. Treatment and prevention 1. For diseased joints, avoid working hard on the upper extremities and reduce weight bearing on the lower extremities as much as possible. 2, the destruction of the heavier joints (such as the knee, elbow and spine parts) can be protected by braces. 3, foot disease and ulcers do not heal can be amputated. Young adult patients with severe destruction of the knee and ankle joints can undergo joint fusion, but the disease can occur again in the adjacent joints. Reduced activity and brace protection are the most effective methods.