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Pedal acrometastasis secondary to urothelial carcinoma masquerading as Charcot arthropathy in a patient with diabetes
  1. Calvin Coe1,
  2. Kedar Chirputkar2,
  3. Leena Joseph3 and
  4. Edward B Jude4
  1. 1Endocrinology and Diabetes, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
  2. 2Trauma and Orthopaedic Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
  3. 3Histopathology, Manchester University NHS Foundation Trust, Manchester, UK
  4. 4The University of Manchester, Manchester, UK
  1. Correspondence to Dr Edward B Jude; edward.jude{at}


A woman in her 80s with known diabetes mellitus and bladder cancer presented to her general practitioner (GP) with pain and swelling in her left foot following trauma. Initial radiographs were reported as normal, prompting a diagnosis of a simple sprain and conservative management. Three months later, the patient was referred to the orthopaedic team due to progressively increasing pain and swelling. Repeat X-rays revealed lytic lesions in both the talus and navicular bones; MRI confirmed the presence of a lytic and proliferative defect in the mid-foot, which was reported as acute Charcot arthropathy with superimposed infection. This was also considered the most likely diagnosis when imaging was reviewed in two separate multidisciplinary team) meetings. However, biopsy demonstrated that the cause of the presentation was in fact acrometastasis from urothelial carcinoma, an infrequently described entity.

  • Diabetes
  • Orthopaedic and trauma surgery
  • Urological cancer

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: CC, KC, EJ and LJ. The following authors gave final approval of the manuscript: CC, KC, EJ and LJ.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.