<prompt> Examine knee x ray carefully. Diagnosis:-TBGoutCharcots diseaseRA  <response>: The given knee x-ray shows bilateral joint destruction. In osteoahritis and rheumatoid ahritis- joint destruction but some anatomical features and shape of joint will be preserved. Gout usually occurs in 1st metatarsal joint. Charcots disease neuropathic ahritis is a cause of joint destruction because of loss of proprioceptive fibers and pain sensibility. It is commonly seen in diabetic patients 