Charcot Joint in Diabetes Mellitus

Diabetic Osteopathy: Report of a Relentlessly Progressive Case, with Clinico‐Pathologic Correlations

“…The possible role of infection in the pathogenesis of these lesions has never been fully resolved, since septic and aseptic bone destruction cannot be distinguished by radiologic means alone (3). The neurotrophic ulcers that occur in most of these patients could serve as a source of infection, but the aspirate from several of the affected joints has been reported as sterile (3, 10). Aspiration of the medial malleolar area in a recent case yielded only sterile, necrotic tissue.…”

“…An inappropriate pulling force transmitted through overstretched tendons may have exceeded the tensile strength of the tibia, resulting in separation of the medial malleolus. Both casting (10) and internal fixation (14) have been recommended as an aid in the treatment of feet that show neurotrophic destruction, and these modalities might well be more useful than bed rest alone in such cases. A quantitative study, in cadaver feet, of forces transmitted to each bone in various positions might improve our understanding of this process.…”

Charcot Joints

“…on January 25, 1963. neuropathic in origin-infection and ischaemia having usually been incriminated. Different writers have differed in the emphasis placed on these three factors: Antes (1954) quoted a case with marked neuropathy without infection or vascular change; Parsons and Norton (1951) reported one in which peripheral vascular changes were marked and which improved after sympathectomy; Copland (1954) believed that infection was the main factor.…”