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Modified Eichenholtz classification

Modified Eichenholtz classification
Stage Radiographic finding Clinical finding Proposed treatment
0 (Prodromal) Normal Swelling, erythema, warmth Patient education, serial radiographs, protected weightbearing
I (Development) Osteopenic, fragmented, joint subluxation or dislocation Swelling, erythema, warmth, ligamentous laxity Protected weightbearing until radiographic resolution of fragmentation and presence of normal skin temperature (usually 2 to 4 months)
II (Coalescence) Absorption of debris, sclerosis, fusion of larger fragments Decreased warmth, decreased swelling, decreased erythema Casting, prefabricated pneumatic brace, Charcot restraint orthotic walker, or clamshell ankle-foot orthosis (6 months to 1 year)
III (Reconstruction) Consolidation of deformity, joint arthrosis, fibrous ankyloses, rounding and smoothing of bone fragments Absence of warmth, absence of swelling, absence of erythema, stable joint ± fixed deformity

Plantigrade foot: Custom shoes

Nonplantigrade foot/ulceration: Surgical reconstruction, deformity correction
From: Rosenbaum AJ, DiPreta JA. Classifications in brief: Eichenholtz classification of Charcot arthropathy. Clin Orthop Relat Res 2015; 473:1168. DOI: 10.1007/s11999-014-4059-y. Copyright © 2015 Association of Bone and Joint Surgeons. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.
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