Charcot neuropathic osteoarthropathy (CNO) is one of the most devastating complications of neuropathy in patients with diabetes. Establishing diagnosis of CNO is difficult, due to the lack of clear clinical and radiological diagnostic criteria. Diagnosis is even more difficult when there is atypical and bilateral clinical presentation. Since CNO may lead to foot deformity, lower-extremity amputation and significant decrements in quality of life, it must be detected and treated without delay. Treatment focuses mainly on interruption of the inflammatory process and relief from pain using feet offloading devices. In more severe cases, surgical intervention may be needed. Additionally, the use of custom-made insoles and custom-made orthopaedic shoes is mandatory. We report a case of a young diabetic patient who presented to our clinic with bilateral and atypical presentation of Charcot foot disease. Patient was treated successfully upon diagnosis with bilateral aircast offloading. Unfortunately, due to depression and non-compliance, the disease progressed to severe and permanent lesions later on. Despite the rareness of this disease, clinicians must include CNO into differential diagnosis of diabetic foot oedema, inflammation and deformity.

中文翻译：

---

夏科特足病的非典型和双侧表现

夏科特神经病性骨关节炎（CNO）是糖尿病患者神经病最具破坏性的并发症之一。由于缺乏明确的临床和放射学诊断标准，难以建立CNO的诊断。当出现非典型和双侧临床表现时，诊断将更加困难。由于CNO可能导致足部畸形，下肢截肢和生活质量显着下降，因此必须立即进行发现和治疗。治疗主要集中在炎性过程的中断和使用脚卸载装置减轻疼痛的治疗上。在更严重的情况下，可能需要手术干预。另外，必须使用定制的鞋垫和定制的矫形鞋。我们报告了一例年轻的糖尿病患者，该患者因双侧和非典型性的夏科特足病出现在我们的诊所。诊断为双侧气播减轻后，患者已成功接受治疗。不幸的是，由于抑郁和不依从，该疾病随后发展为严重和永久性病变。尽管这种疾病很少见，但临床医生必须将CNO纳入糖尿病足水肿，炎症和畸形的鉴别诊断中。