Intended for healthcare professionals

Endgames Spot Diagnosis

A swollen painful foot

BMJ 2016; 355 doi: (Published 02 November 2016) Cite this as: BMJ 2016;355:i5418
  1. Joseph Dalby Sinnott, core surgical trainee1,
  2. David C Howlett, consultant radiologist2
  1. 1Department of Surgery, East Sussex Hospitals NHS Trust, Eastbourne, UK
  2. 2Department of Radiology, East Sussex Hospitals NHS Trust
  1. Correspondence to: J D Sinnott j.d.sinnott{at}

A 59 year old woman with diabetes mellitus presented to her general practitioner with a swollen, erythematous, and painful left foot. Her symptoms had been worsening over several months. There was no history of a recent trauma. A plain radiograph was obtained (fig 1). What does this show?

Fig 1 Plain x ray of a left foot


Neuropathic osteoarthropathy, sometimes known as a Charcot foot.


The findings on the radiograph are consistent with advanced neuropathic osteoarthropathy, …

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