There are two main classifications of Charcot neuroarthropathy.
Eichenholz classification: disease progress
The Eichenholz classification describes the evolution of the condition through time:
- Stage 1 – destruction
- Stage 2 – coalescence
- Stage 3 – consolidation
A "stage 0" has come into use to describe the swollen, hot, usually somewhat painful foot in which plain Xrays are normal. MR, however, shows bone oedema and stress fractures.
"Stage 0" - hot foot, normal Xrays. MR shows bone oedema and fractures
Stage 1 - fragmentation, bone resorption, dislocations, fractures
Stage 2 - coalescence, sclerosis, fracture healing, debris resorption
Stage 3 - remodelling
Brodsky classification: disease distribution
Charcot arthropathy usually begins in the tarsometatarsal region, but sometimes it is seen in the midtarsal or ankle joints, or as pathological calcaneal fractures. The distribution is usually expressed by the Brodsky classification. Schon has described a more precise classification, which has been validated, but it has not yet been shown that the additional complexity is clinically useful.
Type 1 (tarsometatarsal and lesser tarsus)
Type 2 (peritalar)
Type 3a (ankle) and 3b (posterior calcaneum)
Trepman added type 4 (multiple sites) and type 5 (forefoot) as shown here