Charcot Neuroarthropathy: From the Laboratory to the Bedside

Pitocco, Dario; Scavone, Giuseppe; Leo, Mauro Di; Vitiello, Raffaele; Rizzi, Alessandro; Tartaglione, Linda; Costantini, F E; Flex, Andrea; Galli, Marco; Caputo, Salvatore; Ghirlanda, Giovanni; Pontecorvi, Alfredo

doi:10.2174/1573399815666190502121945

Cited by 20 publications

(23 citation statements)

References 107 publications

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“…Radiographic images provide important information on anatomy and bone alignment, and one should always look for signs of fractures, dislocations, consolidations, and eventual radiological signs of osteomyelitis. However, our findings usually follows what was described by Eichenholtz (11,32) .…”

Section: Stagesupporting

confidence: 92%

“…The treatment is eminently multidisciplinary, with medical, nursing, and physiotherapy professionals working to control comorbidities and promote dressing changes and rehabilitation (31,32,35) . Orthopedic goal of CN treatment is to obtain and maintain a stable, plantigrade foot with satisfactory alignment, allowing weight-bearing, use of shoes or orthoses, performing of daily activities, and avoiding ulcerations and amputations (15,32,36,37) .…”

Section: Treatmentmentioning

confidence: 99%

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Charcot arthropathy of the foot and ankle

et al. 2021

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To critically evaluate the current literature on the etiopathogenesis of Charcot neuroarthropathy, its diagnostic methods and therapeutic management. Methods: We searched for studies that related Charcot arthropathy with a location in the foot and ankle in the PUBMED and MEDLINE databases. Results: A total of 52 studies were used for this analysis. Conclusion: Charcot neuroarthropathy is a serious disease with significant potential to impact patient quality of life. Although its pathogenesis still raises much controversy, neuropathy seems to have a central role, leading to a trauma, injury, and inflammation cycle. Level of Evidence V; Therapeutic Studies; Expert Opinion.

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Section: Stagesupporting

confidence: 92%

Section: Treatmentmentioning

confidence: 99%

Charcot arthropathy of the foot and ankle

et al. 2021

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“…These treatments include the administration of antiresorptive agents (bisphosphonates and calcitonin), anabolic agents (recombinant parathyroid human hormone), or anti-RANKL monoclonal antibody (denosumab). However, the clinical efficacy of these agents is still inconclusive (reviewed in [37,40]).…”

Section: Treatmentmentioning

confidence: 99%

The role of genetic factors and monocyte-to-osteoclast differentiation in the pathogenesis of Charcot neuroarthropathy

Kłoska

Korzon-Burakowska

Malinowska

et al. 2020

Diabetes Research and Clinical Practice

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Charcot neuroarthropathy is a chronic, progressive condition of the skeletal system that affects some patients with diabetic neuropathy. It results in progressive destruction of bones of the foot and disorganisation of pedal joints and ligaments. Effective prevention and treatment for Charcot neuroarthropathy remain a challenge. Currently, there are no reliable repeatable markers to identify patients with diabetes who are at higher risk of developing Charcot neuroarthropathy. The pathogenesis underlying the development of Charcot neuroarthropathy also remains unclear. In this review, we provide an overview of the history, prevalence, symptoms, risk factors, diagnostics and treatment of Charcot neuroarthropathy. We also discuss the potential for OPG and RANKL gene variants to act as predictive markers for the development of Charcot neuroarthropathy. Finally, we summarise the latest research on the role of monocyte-to-osteoclast differentiation in the development of acute Charcot neuroarthropathy.

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“…CN is a progressive and destructive bone and joint disease that can affect single or multiple joints of the foot and ankle [ 1 , 2 , 5 ]. It is characterised by acute fractures, joint subluxation, dislocation and instability, and bony destruction [ 2 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…It is characterised by acute fractures, joint subluxation, dislocation and instability, and bony destruction [ 2 , 6 , 7 ]. Acute CN typically presents as a warm, erythematous, and oedematous foot [ 5 ]. Misdiagnosis in its early stages can lead to gross foot deformity, ulceration and amputation [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Infrared dermal thermometry is highly reliable in the assessment of patients with Charcot neuroarthropathy

Dallimore

Puli

Kim

et al. 2020

Journal of Foot and Ankle Research

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Background Charcot neuroarthropathy (Charcot foot) is a serious limb-threatening complication most commonly seen in individuals with diabetic peripheral neuropathy. Although dermal thermometry is widely used by clinicians to assist in the diagnosis, monitoring, and management of the disease, there is limited high-quality evidence to support its reliability. Therefore, this study investigated the intra-rater and inter-rater reliability of infrared dermal thermometry in patients with Charcot neuroarthropathy. Methods We collected clinical, demographic, health status, and foot examination information on 32 adults with Charcot neuroarthropathy from a metropolitan high-risk foot service in Melbourne, Australia. Infrared dermal thermometry assessments were conducted by two independent raters at 10 anatomical sites of the Charcot foot using both a (i) touch and (ii) non-touch technique. Intra-rater and inter-rater reliability of the two assessment techniques were evaluated using intra-class correlation coefficients (ICCs), limits of agreement, standard error of measurement, and minimal detectable change statistics. Results Mean age was 59.9 (standard deviation [SD], 10.5) years, 68.8% were male, average duration of diabetes was 20.6 (SD, 15.1) years, 71.9% had type 2 diabetes, 93.8% had peripheral neuropathy, 43.8% had peripheral arterial disease, and 50% had previous foot ulceration. Charcot foot most commonly affected the tarsometatarsal joints (38.9%), had a median duration of 2.8 (interquartile range [IQR], 1.3 to 5.9) months, and a large proportion were being treated with total contact casting (69.4%). Overall, there was good to excellent intra-rater and inter-rater relative reliability for the ‘touch’ technique (ICC, 0.87 to 0.99; ICC, 0.83 to 0.98, respectively), and excellent intra-rater and inter-rater relative reliability for the ‘non-touch’ technique (ICC, 0.93 to 0.99; ICC, 0.91 to 0.99, respectively). In addition, measurement error was found to be relatively low across the 10 anatomical sites. Conclusions Infrared dermal thermometry can now be used with confidence in clinical and research settings to provide a reliable assessment of skin temperature in patients with Charcot neuroarthropathy, using either a touch or non-touch technique at 10 commonly used testing sites. A non-touch technique, however, was observed to have slightly higher reliability indicating it may be associated with less measurement error than the touch technique.

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Charcot Neuroarthropathy: From the Laboratory to the Bedside

Cited by 20 publications

References 107 publications

Charcot arthropathy of the foot and ankle

Charcot arthropathy of the foot and ankle

The role of genetic factors and monocyte-to-osteoclast differentiation in the pathogenesis of Charcot neuroarthropathy

Infrared dermal thermometry is highly reliable in the assessment of patients with Charcot neuroarthropathy

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