- Causes are Diabetes mellitus, Syringomyelia, Spinal cord tumors, Meningomyelocele, Extrinsic compression of the spinal cord, Peripheral nerve tumors, Multiple sclerosis, Congenital insensitivity to pain, Hereditary sensory and motor neuropathy
- Absenceof normal protective sensory feedback
- Repetitive mechanical trauma causes progressive joint destruction
- X rays show hypertrophic joint: manifested radiologically as joint destruction and fragmentation, osseous sclerosis, and osteophyte formation or atrophic type: completely resorbed atrophic joint
- Fractures easily with minor trauma, typically transverse type and heal with exuberant callus
- In upper limb it may present as neuropathic arthropathy of shoulder joint, spontaneous rupture of tendons, claw fingers etc
- Neuropathic ankle and foot are common in lower limb presentations
