Figure 28.

Neuropathic osteoarthropathy without infection in a 64-year- old diabetic man. Sagittal T1-weighted magnetic resonance image demon- strates characteristic articular-centered abnormalities with fragmentation of the navicular bone and intra-articular bone fragments (white arrow), subchondral cyst-like changes (black arrows), preservation of normal sub- cutaneous fat signal (arrowhead) near bone marrow signal abnormality, and absence of skin ulcer. Loss of normal marrow fat signal on T1-weighted images may be related to sclerosis, frequently seen in the setting of Charcot arthropathy without superimposed infection