A Specific and Reliable Test for Charcot Neuropathy is Still Missing

Abstract

Background: Charcot Neuropathy is a severe complication of patients with neuropathy mostly seen in the foot, but it can also appear in the knee or hand. Not only diabetic patients are involved. CN can lead to a complete collapse of the foot with subsequent ulceration and infection. The mechanism of this episode-like breakdown has not been understood so far. CN still remains mainly a clinical diagnosis depended on clinical experience because there is still no reliable and specific test even though imaging has improved. X-rays represent the traditional way to diagnose CN according to the classification of Eichenholtz of 1967. But at the time these alterations become visible, the bone is already damaged. Therefore Shiabata introduced the MRI as Stage 0 into this existing classification. New approaches using CT or PET/CT have been published.