Charcot neuropathic arthropathy has several causes, of which the most common is diabetes mellitus [10]. Other causes include several unrelated diseases that are complicated by nerve injury, including infection-related distal neuropathies (e.g., leprosy and syphilis), diseases of the spinal cord and nerve roots (e.g., tabes dorsalis, trauma, and syringomyelia), systemic diseases (e.g., Parkinson’s disease, human immunodeficiency virus, sarcoidosis, rheumatoid disease, and psoriasis) [9], and toxins (e.g., ethanol and drug use) [11,12]. In our patient, the aforementioned causes were excluded based on the history, laboratory, and radiological findings. Our patient is similar to the previously reported case of knee Charcot neuropathic arthropathy that developed after nerve damage sustained during previous spinal surgery [7]. Our patient developed a superimposed infection that led to a high CRP level and growth of MSSA on the blood and tissue culture. The pathophysiology of Charcot neuropathic arthropathy involves increased blood flow to the bones due to damage to the sympathetic nerves, which results in bone resorption and weakening, ultimately leading to fractures and deformities [13]. Charcot neuropathic arthropathy is a chronic and progressive disease that is often difficult to diagnose [14]. The characteristic radiological findings of Charcot arthropathy include progressive bony destruction; however, there are no isolated laboratory or radiological findings that can confirm the diagnosis. Therefore, follow-up evaluation is often required [15]. Additionally, infection cannot be reliably excluded in cases with radiological findings of bony destruction. Therefore, laboratory and radiology examinations are often performed for patients with bony destruction [16]. In cases with infection, arthroscopy or incision and drainage and intravenous antibiotics, may be required. If the follow-up imaging reveals continued bone collapse despite no evidence of major trauma even after the infection has been treated, the possibility of Charcot neuropathic arthropathy should be considered [17]. The risk of Charcot arthropathy is particularly high in cases of neurological deficits, such as in our patient.

The limitation of this case report is that it describes a single case of Charcot arthropathy. Additionally, the pathophysiology of Charcot arthropathy was not explored. Despite early diagnosis and treatment of Charcot arthropathy, the disease continued to progress in our patient. The possibility of Charcot neuropathic arthropathy should be considered in patients with a history of neural trauma sustained during spinal surgery.