Charcot-like Arthropathy in Rheumatoid Arthritis

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Abstract
PAIN is a necessary evil, a mechanism for protection against dangers that surround us. Congenital inability to perceive pain may lead to such serious corporal damage as multiple skeletal deformities and Charcot's joints.1Intra-articular injections of corticoids may produce, at least temporarily, a relatively painless joint even in serious rheumatoid involvement. Abuse of joints thus rendered painless could cause articular damage more severe than that expected in the natural course of the disease. Recently, we have observed a patient in whom rheumatoid arthritis, stoicism, repeated intraarticular injections of hydrocortisone, and excessive weight-bearing activity resulted in articular destruction of the type seen in Charcot's arthropathy. Report of a Case A 47-year-old housewife was seen at our clinic initially in 1950. She had had swollen, hot, tender knees for two months when she was 15 years old. In 1942, pain, stiffness, and swelling of the proximal interphalangeal joints of both hands

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