The diabetic foot with synovial cyst.

Diabetic lower extremity infections, frequently polymicrobial, are at times fascinating though frustrating for the practitioner to treat. The classical triad of neuropathy, infection, and angiopathy is the hallmark of diabetic foot pathology. One of the main forms demonstrating the severe long-term neuropathic disease is called osteoarthropathy or Charcot joint. This is usually relatively painless, always progressive, and frequently destructive. It generally attacks the midtarsal joint and eventually changes the entire architecture of the foot, causing the so-called "rocker bottom" foot type. We present a case of a severely destructive Charcot foot that caused a large synovial cyst because of its vast underlying osseous pathology. The morbidity and mortality of these infections can be minimized by understanding the unique challenges these individuals offer the practitioner.