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Charcot osteoarthropathy

Joanne Dixon, Joshua Coulter, Michele Garrett, Rick Cutfield
AIMS: To review the characteristics, management and outcomes one year after diagnosis in patients with diabetes related charcot neuropathic osteoarthropathy (CN) treated at the Diabetes Podiatry service, Waitemata District Health Board (WDHB) between 2000-2014. METHODS: Patients with diabetes and recorded diagnosis of CN were identified from the podiatry service records. Clinical details were retrospectively obtained from WDHB databases and patient medical records...
December 15, 2017: New Zealand Medical Journal
L Meacock, N L Petrova, Ana Donaldson, A Isaac, A Briody, R Ramnarine, M E Edmonds, D A Elias
There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0-no oedema, 1-oedema < 50% of bone volume, and 2-oedema > 50% of bone volume) and fracture (0-no fracture, 1-fracture, and 2-collapse/fragmentation)...
2017: Journal of Diabetes Research
Levent Adiyeke, Mehmet Oǧuz Durakbaşa, Tahir Mutlu Duymuş
Neuropathic osteoarthropathy, which is known as Charcot osteoarthropathy, is a degenerative arthritis that develops as a result of proprioceptive and sensory innervation loss. A 47-year-old man was admitted to the emergency department of the hospital with left shoulder pain, which was ongoing and exacerbating for 5 days. Examination of the cervical region takes a crucial part in determining shoulder pathology. Palliative therapy is the prior treatment of choice as surgical therapy has potential risks in Charcot osteoarthropathy...
April 6, 2017: Clinics and Practice
David R Sinacore, Kathryn L Bohnert, Kirk E Smith, Mary K Hastings, Paul K Commean, David J Gutekunst, Jeffrey E Johnson, Fred W Prior
AIMS: To determine local and systemic markers of inflammation and bone mineral density (BMD) in the foot and central sites in participants with diabetes mellitus and peripheral neuropathy (DMPN) with and without acute Charcot neuropathic osteoarthropathy (CN). METHODS: Eighteen participants with DMPN and CN and 19 participants without CN had foot temperature assessments, serum markers of inflammation [C-reactive protein, (CRP) and erythrocyte sedimentation rate, (ESR)] and BMD of the foot, hip and lumbar spine at baseline and 1year follow-up...
June 2017: Journal of Diabetes and its Complications
Alexander T Mehlhorn, Markus Walther, Niklas Iblher, Norbert P Südkamp, Hagen Schmal
In Charcot's osteoarthropathy stabilization of the medial column of the foot was introduced in order to establish a stable foot and reduce the risk for amputation. This study was performed to analyze postoperative complications, define risk factors for those and develop strategies for prevention. Since bolt dislocation takes place frequently, it was aimed to predict an appropriate time point for bolt removal under the condition that osseous healing has occurred. Fourteen consecutive patients with neuroosteoarthropathy of the foot and arch collapse were treated with open reduction and stabilization using midfoot fusion bolt and lateral lag screws...
December 2016: Foot
Ashu Rastogi, Anil Bhansali
No abstract text is available yet for this article.
May 2017: Postgraduate Medical Journal
Patrick Goetti, Nicolas Gallusser, Olivier Borens
Diabetic osteoarthropathy is a rare cause of neuropathic joint disease of the knee; bilateral involvement is even more exceptional. Diagnosis is often made late due to its unspecific symptoms and appropriate surgical management still needs to be defined, due to lack of evidence because of the disease's low incidence. We report the case of a forty-year-old woman with history of diabetes type I who developed bilateral destructive Charcot knee arthropathy. Bilateral total knee arthroplasty was performed in order to achieve maximal functional outcome...
2016: Case Reports in Orthopedics
K Trieb
Neuropathic changes in the foot are common with a prevalence of approximately 1%. The diagnosis of neuropathic arthropathy is often delayed in diabetic patients with harmful consequences including amputation. The appropriate diagnosis and treatment can avoid an extensive programme of treatment with significant morbidity for the patient, high costs and delayed surgery. The pathogenesis of a Charcot foot involves repetitive micro-trauma in a foot with impaired sensation and neurovascular changes caused by pathological innervation of the blood vessels...
September 2016: Bone & Joint Journal
Mateusz Płaza, Anna Nowakowska-Płaza, Marta Walentowska-Janowicz, Marek Chojnowski, Iwona Sudoł-Szopińska
This article presents a patient with a long history of type 1 diabetes mellitus complicated with neuropathy and Charcot disease. The most common cause of neuropathic osteoarthropathy, called Charcot osteoarthropathy, is poorly controlled diabetes. The clinical picture is characterized by considerable edema, redness and increased skin temperature with relatively slight pain due to injury to nerve fibers responsible for pain sensation. The differential diagnosis should include bacterial or autoimmune arthritis, arthritis associated with gout as well as venous thrombosis and injury...
June 2016: Journal of Ultrasonography
Andreas M Hingsammer, David Bauer, Niklas Renner, Paul Borbas, Thomas Boeni, Martin Berli
BACKGROUND: Charcot osteoarthropathy (COA) is characterized by a progressive destruction of bone and joint associated with neuropathy and is most common in the foot and ankle. Clinical manifestation of COA is frequently indistinguishable from other causes of pain, swelling, and erythema of the affected extremity, in particular, infection. Diagnosis of COA can be challenging in particular in early stages where radiographic changes are sparse. The presence of elevated systemic inflammatory parameters in the context of suspected infection may delay early diagnosis and treatment of COA...
September 2016: Foot & Ankle International
Jamie M Womack
Charcot disease is a neurogenic osteoarthropathy that occurs in the foot and ankle following the loss of normal muscle tone, vascularization, and protective reflexes. Diabetes is its most common cause in the Western world. Fragmentation, destruction, and dislocation of the bones can occur spontaneously or after trauma. This article describes the care of a patient with Charcot disease.
May 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Jeremy M Sullivan, Christina M Zimanyi, William Aisenberg, Breanne Bears, Dong-Hui Chen, John W Day, Thomas D Bird, Carly E Siskind, Rachelle Gaudet, Charlotte J Sumner
OBJECTIVE: To characterize 2 novel TRPV4 mutations in 2 unrelated families exhibiting the Charcot-Marie-Tooth disease type 2C (CMT2C) phenotype. METHODS: Direct CMT gene testing was performed on 2 unrelated families with CMT2C. A 4-fold symmetric tetramer model of human TRPV4 was generated to map the locations of novel TRPV4 mutations in these families relative to previously identified disease-causing mutations (neuropathy, skeletal dysplasia, and osteoarthropathy)...
December 2015: Neurology. Genetics
Azam Arsanjani Shirazi, Morteza Nasiri, Leila Yazdanpanah
AIMS: Diabetic Foot Syndrome (DFS) is the most costly and devastating complication of diabetes mellitus (DM), which early effective assessment can reduce the severity of complications including ulceration and amputations. This study aimed to review dermatological and musculoskeletal assessment of diabetic foot. MATERIALS AND METHODS: In this review article, we searched for articles published between March 1, 1980 and July 28, 2015 in PubMed, Science Direct, Embase, Web of Science, and Scopus, for both English and non-English language articles with the following keywords: "Diabetic foot syndrome", "Ulceration", "Amputation", "Foot assessment", "Skin disorders" and "Musculoskeletal deformities"...
April 2016: Diabetes & Metabolic Syndrome
Luca Dalla Paola, Anna Carone, Marco Baglioni, Giulio Boscarino, Lucian Vasilache
AIMS: Charcot neuropathic osteoarthropathy (CN) represents a complication for diabetic patients which involves a progressive alteration of the osteoarticular apparatus with high risk of amputation. The aim of the study was to assess whether the localization of CN and the extent or grading of the osteomyelitis have an influence on the rate of limb salvage and the time to recovery. METHODS: We treated a diabetic population affected by CN complicated by ulceration and widespread osteomyelitic involvement...
May 2016: Journal of Diabetes and its Complications
Laura N McEwen, Kelly R Ylitalo, Michael Munson, William H Herman, James S Wrobel
BACKGROUND: We sought to study the impact of foot complications on 10-year mortality independent of other demographic and biological risk factors in a racially and socioeconomically diverse managed-care population with access to high-quality medical care. METHODS: We studied 6,992 patients with diabetes in Translating Research Into Action for Diabetes (TRIAD), a prospective observational study of diabetes care in managed care. Foot complications were assessed using administrative claims data...
January 2016: Journal of the American Podiatric Medical Association
Gustavo M de Almeida, Francisco M B Germiniani, Hélio A G Teive
The authors review the most important contributions of Pierre Marie to the elucidation and description of several neurological diseases, such as Charcot-Marie-Tooth's disease and hereditary cerebellar ataxia, as well as his contributions to Internal Medicine, including his pioneering studies on acromegaly, ankylosing spondylitis, and hypertrophic pulmonary osteoarthropathy. His works led to incontestable advances in the medical sciences that transcended his time.
October 2015: Arquivos de Neuro-psiquiatria
M Fosbøl, S Reving, E H Petersen, P Rossing, M Lajer, B Zerahn
AIM: To investigate whether inclusion of quantitative data on blood flow distribution compared with visual qualitative evaluation improve the reliability and diagnostic performance of 99 m Tc-hydroxymethylene diphosphate three-phase bone scintigraphy (TPBS) in patients suspected for charcot neuropathic osteoarthropathy (CNO) of the foot. METHOD: A retrospective cohort study of TPBS performed on 148 patients with suspected acute CNO referred from a single specialized diabetes care centre...
January 2017: Clinical Physiology and Functional Imaging
Rasmus Bo Jansen, Tomas Møller Christensen, Jens Bülow, Lene Rørdam, Per E Holstein, Ole Lander Svendsen
BACKGROUND: Treatment of Charcot osteoarthropathy (COA) requires restricted walking and offloading for several months, which lead to fat re-distribution and increased sarcopenia. OBJECTIVES/AIM: To investigate whether subjects with COA have an altered body composition compared to controls. METHODS: Cross-sectional case-control study of people with diabetes with acute or chronic Charcot osteoarthropathy, matched with otherwise healthy people with diabetes...
September 2015: Journal of Diabetes and its Complications
Nina L Petrova, Peter K Petrov, Michael E Edmonds, Catherine M Shanahan
We hypothesised that tumour necrosis factor-α (TNF-α) may enhance receptor activator of nuclear factor-κβ ligand- (RANKL-) mediated osteoclastogenesis in acute Charcot osteoarthropathy. Peripheral blood monocytes were isolated from 10 acute Charcot patients, 8 diabetic patients, and 9 healthy control subjects and cultured in vitro on plastic and bone discs. Osteoclast formation and resorption were assessed after treatment with (1) macrophage-colony stimulating factor (M-CSF) and RANKL and (2) M-CSF, RANKL, and neutralising antibody to TNF-α (anti-TNF-α)...
2015: Journal of Diabetes Research
Bilal Bin Younis, Adeela Shahid, Rozina Arshad, Saima Khurshid, Junaid Masood
BACKGROUND: Charcot osteoarthropathy or charcot foot is a rare, chronic, non-communicable condition of bones and joints which may results into severe deformity and more prone to develop ulcers possibly leading to amputation. The purpose of this study was to determine the prevalence of Charcot osteoarthropathy and its association with age, BMI, gender, duration of diabetes, HBA1c and peripheral neuropathy. METHODS: A total of 1931 subjects with type 2 diabetes having mean age 50...
2015: BMC Endocrine Disorders
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