Clinical picture of diabetic osteoarthropathy

Abstract

On the basis of data from pertinent literature and of a thorough examination of 23 cases observed by himself the author illustrates findings concerned the occurrence, clinical picture and interrelations of clinical and radiological symptoms in diabetic osteoarthropathy. These alterations occur most frequently in middleaged or elderly diabetic patients with unstable metabolism or poor control, usually after a long duration of diabetes. Clinical symptoms are divided into 4 groups. Neurological symptoms (group I) are detectable at every stage of the process. Sometimes bone destruction is concomitant but neurological changes are the sole symptoms. Loose joints and articular swelling (group II) are frequently premonitory signs of bone alterations. Plantar ulcers (group III) are often associated with bone changes. Detectable foot deformities (group IV) are mostly an indication of the end stage of the process.

Use of a Retrograde Nail for Ankle Arthrodesis in Charcot Neuroarthropathy: A Limb Salvage Procedure

“…The prevalence of diagnosed neuroarthropathy associated with diabetes mellitus has been reported to be from 0.08% to 7.5%. 2,6,8,12,15,16,17,20,22 According to the classification by Sanders et al, 18,19 there are five sites of Charcot neuroarthropathy. In 1992, Brodsky 3 developed another anatomical classification for Charcot neuroarthropathy, but the most comprehensive anatomic categorization is the system by Schon et al 21 The ankle is an infrequent site (around 5%) for Charcot neuroarthropathy but is definitely the location that, because of the instability and progressive deformity it involves, causes ulceration in a high percentage of patients, and this can then become a reason for amputation ( Figure 1).…”