Diabetic Charcot neuroarthropathy of the knee in a patient with type-1 diabetes mellitus

Miguel, Gonzalo Allo; Fernández, Elena; Carranza, Federico Hawkins

doi:10.1007/s12020-014-0466-9

Cited by 2 publications

(8 citation statements)

References 3 publications

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“…Specific triggers are sometimes described, for example a misstep whilst hiking on the Appalachian Trail [ 60 ], or traumatic incidents [ 15 , 23 , 25 , 35 , 43 ]. Pain Twenty-one studies involving 52 patients described a degree of pain and tenderness as a presenting complaint [ 7 , 16 , 17 , 19 – 24 , 28 , 35 , 37 , 38 , 44 , 47 , 54 , 57 – 61 ] especially during movement [ 21 , 37 , 57 ]. However, neuropathic arthropathy is classically described as a painless condition, with 9 studies involving 11 patients reporting an initial painless presentation [ 6 , 8 , 12 , 13 , 15 , 36 , 39 , 41 , 48 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patient ethnicity was reported by 8 studies involving 17 patients, mostly in those that were published in the twentieth century. Among them, 50% were Caucasian, 41.7% Afro-Caribbean origin, and 8.3% Asian [12][13][14][15][16][17][18][19]. Table 1 shows aetiologies of CK patients.…”

Section: Demographicsmentioning

confidence: 99%

“…Valgus deformation was reported in 19 studies involving 114 patients [4, 7, 9, 12, 19, 28, 34, 35, 37, 38, 45, 49-51, 53-55, 57, 58] and varus deformation in 14 studies involving 34 patients [8,16,21,24,28,30,31,34,35,37,43,53,54,62], often presenting as instability upon valgus and varus stress tests, or a positive Bohler test [52]. Ligamentous laxity and joint hypermobility were reported in 7 studies involving 14 patients [7,19,22,26,32,50,53].…”

Section: Knee Deformitiesmentioning

confidence: 99%

“…e. Histopathology Most studies did not perform histopathological analysis, yet those that did report findings pathognomonic for CK, such as hyperplastic inflamed synovium with bone and cartilage detritus [5,9,20,28,52] with fibrous pannus invasion, denoting a rapid breakdown of the joint [5,21,28]. Subchondral sclerosis with fibrous hyalinised tissue were reported by a five studies involving one patient each [7,16,20,39,52]. Histopathological analysis is key to pinpointing CK, differentiating it from isolated insufficiency fractures that could be related to osteonecrosis or chronic mineral imbalance.…”

Section: Knee Deformitiesmentioning

confidence: 99%

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Charcot knee — presentation, diagnosis, management — a scoping review

Zhang

Thahir

et al. 2021

Clin Rheumatol

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Background Charcot arthropathy is a progressive, non-infectious, destructive inflammatory process. Charcot arthropathy of the knee (CK) is rare and diagnosis is often delayed, resulting in detrimental outcomes. This scoping review aims to investigate the literature on CK, present the pathognomonic features of CK to aid early diagnosis, and suggest gaps in the literature for future research. Methods A systematic search of PubMed, EMBASE, Web of Science for literature relevant to CK was performed. Primary studies such as case reports, case series, retrospective studies were included. Review articles and animal studies were excluded. Results Of the 513 results, 58 were included in qualitative synthesis. Average time from symptom onset to CK diagnosis was 50.5 months. Eighteen and twenty-one studies included patients who had diabetes mellitus and syphilis, respectively. Twenty-one studies reported pain as a presenting complaint, but the degree of pain didn’t correspond with the level of destruction. Oedema and joint effusion were noticed in 34 studies. Twenty-nine studies reported lower limb hypoesthesia and 17 studies reported decreased tendon reflex. Twenty-eight studies reported initial conservative treatment, often in a knee brace with minimal weight bearing, 9 of which needed subsequent surgical management. Twelve studies utilised arthrodesis, with fracture at the intramedullary nail entry site being the most common complication. Twenty-four studies utilised TKA. Conclusion The literature on CK remains sparse, with most publications being case reports. Given that CK dramatically reduces quality of life, increases morbidity of patients, there is need for more literature on evidence-based options for early diagnoses and management.

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Section: Resultsmentioning

confidence: 99%

Section: Demographicsmentioning

confidence: 99%

Section: Knee Deformitiesmentioning

confidence: 99%

Section: Knee Deformitiesmentioning

confidence: 99%

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Charcot knee — presentation, diagnosis, management — a scoping review

Zhang

Thahir

et al. 2021

Clin Rheumatol

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“…Complete rest may not be appropriate if patients present with gross deformity. Miguel et al [ 7 ] describe a case of CK where stability of a severely varus knee was attempted by external fixation for 5 months. Thereafter, there was eventual need for conversion to a full knee-ankle orthosis.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Neuropathic Arthropathy of the Knee: Two Case Reports and a Review of the Literature

Patel

Saini

Edmonds

et al. 2018

Case Reports in Orthopedics

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Diabetic neuroarthropathy of the knee or Charcot knee (CK) is a lesser-known complication of diabetes mellitus, with a limited number of case reports and small case series published in the literature. The majority of these reports describe the complexities and challenges that arise in these patients undergoing knee arthroplasty procedures. We present two cases of CK, including a rare case of concurrent bilateral disease, and also a review of the current literature.

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Diabetic Charcot neuroarthropathy of the knee in a patient with type-1 diabetes mellitus

Cited by 2 publications

References 3 publications

Charcot knee — presentation, diagnosis, management — a scoping review

Charcot knee — presentation, diagnosis, management — a scoping review

Diabetic Neuropathic Arthropathy of the Knee: Two Case Reports and a Review of the Literature

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