Bisphosphonates in the treatment of Charcot neuroarthropathy
: a double-blind randomised controlled trial.
The incidence of Charcot neuroarthropathy
in persons with diabetes is estimated to be 0.12% (6).
The rankl/rank/opg signaling pathway mediates medial arterial calcification in diabetic charcot neuroarthropathy
. Diabetes 2011; 60: 2187-2196, doi: 10.2337/db10-1220.
(25,26) Atrophic neuroarthropathy
is characterized by bone resorption, while hypertrophic neuroarthropathy
is frequently mistaken for hypertrophic osteoarthritis with findings of sclerosis, debris, fragmentation, and the presence of exuberant osteophytes.
Shortening osteotomy for the treatment of spinal neuroarthropathy
following spinal cord injury.
Tesfaye, "Charcot neuroarthropathy
in diabetes mellitus," Diabetologia, vol.
He was placed in a total contact cast for the foot with a clinical diagnosis of acute Charcot neuroarthropathy
. An MRI of the right knee was performed which demonstrated minor bone oedema to the medal femoral condyle in keeping with a third episode of CK in the right knee.
The three main pathologies that are associated with diabetic foot syndrome (DFS) are diabetic peripheral neuropathy, peripheral arterial disease and/or infection.1 The syndrome also encompasses complications like Charcot neuroarthropathy
, osteomyelitis, foot ulceration and may lead to the most feared outcome, amputation.1 The prevalence of foot ulcers is reported to range from 4.0% to10.0% in patients with diabetes, which suggests that lifetime risk of developing foot ulcers in these patients may be as high as 25.0%.2-4 Of all the non-traumatic lower limb amputations, 8 out of 10 amputations are done in patients with diabetes, out of which 85.0% follow a foot ulcer.2,5,6
Given the ankle joint's inherent stability, the most common cause of ankle OA is trauma, (4) mainly ankle fracture and, less commonly, ligamentous injury.5'6 Other rarer causes of ankle arthritis include primary OA, crystalline arthropathy, inflammatory disease, septic arthritis, neuroarthropathy
, hemochromatosis, and ochronosis.
(5) showed that of the various rheumatological manifestations adhesive capsulitis, shoulder hand syndrome, diabetic hand syndrome diffuse idiopathic skeletal hyperostosis, Dupuytren's disease and neuroarthropathy
are characteristically associated with diabetes mellitus.
Evaluation and treatment of stage 0 Charcot's neuroarthropathy
of the foot and ankle.
Where indicated, serial imaging could identify changes in patients consistent with a neuroarthropathy
. The treatment in these cases would be nonweight-bearing on the affected side until the sensory innervation (ie, pain) returns.