Pathogenesis of Charcot Neuroarthropathy and Acute Management

Petrova, Nina L.; Edmonds, Michael

doi:10.1002/9781119445821.ch19

Cited by 3 publications

(2 citation statements)

References 43 publications

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“… 20 In CN, blood chemical and haematological markers are usually normal or only marginally outside reference ranges, unless there is concurrent infection. 25 …”

Section: The Diagnosis and Monitoring Of Cnmentioning

confidence: 99%

“…20 In CN, blood chemical and haematological markers are usually normal or only marginally outside reference ranges, unless there is concurrent infection. 25 As the disease process of CN progresses, signs of inflammation usually resolve; however, the clinician faces the challenge of determining when complete remission has occurred. The presence of neuropathy means that subjective symptoms are often absent, and the signs of inflammation can be subtle, and this can make it difficult to assess when the foot has gone into remission.…”

Section: The Diagnosis and Monitoring Of Cnmentioning

confidence: 99%

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Controversies in the management of active Charcot neuroarthropathy

Gooday

Hardeman

Poland

et al. 2023

Therapeutic Advances in Endocrinology

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Charcot neuroarthropathy (CN) was first described over 150 years ago. Despite this there remains uncertanity around the factors that contribute to its development, and progression. This article will discuss the current controversies around the pathogenesis, epidemiology, diagnosis, assessment and management of the condition. The exact pathogenesis of CN is not fully understood, and it is likely to be multifactorial, with perhaps currently unknown mechanisms contributing to its development. Further studies are needed to examine opportunities to help screen for and diagnose CN. As a result of many of these factors, the true prevalence of CN is still largely unknown. Almost all of the recommendations for the assessment and treatment of CN are based on low-quality level III and IV evidence. Despite recommendations to offer people with CN nonremovable devices, currently only 40–50% people are treated with this type of device. Evidence is also lacking about the optimal duration of treatment; reported outcomes range from 3 months to more than a year. The reason for this variation is not entirely clear. A lack of standardised definitions for diagnosis, remission and relapse, heterogeneity of populations, different management approaches, monitoring techniques with unknown diagnostic precision and variation in follow-up times prevent meaningful comparison of outcome data. If people can be better supported to manage the emotional and physical consequences of CN, then this could improve people’s quality of life and well-being. Finally, we highlight the need for an internationally coordinated approach to research in CN.

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“… 20 In CN, blood chemical and haematological markers are usually normal or only marginally outside reference ranges, unless there is concurrent infection. 25 …”

Section: The Diagnosis and Monitoring Of Cnmentioning

confidence: 99%

Section: The Diagnosis and Monitoring Of Cnmentioning

confidence: 99%

Controversies in the management of active Charcot neuroarthropathy

Gooday

Hardeman

Poland

et al. 2023

Therapeutic Advances in Endocrinology

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Biomarkers of local inflammation at the skin's surface may predict both pressure and diabetic foot ulcers

Wilson,

Patton,

O'Connor

et al. 2024

J Wound Care

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This commentary considers the similarities which exist between pressure ulcers (PUs) and diabetic foot ulcers (DFUs). It aims to describe what is known to be shared—both in theory and practice—by these wound types. It goes on to detail the literature surrounding the role of inflammation in both wound types. PUs occur following prolonged exposure to pressure or pressure in conjunction with shear, either due to impaired mobility or medical devices. As a result, inflammation occurs, causing cell damage. While DFUs are not associated with immobility, they are associated with altered mobility occurring as a result of complications of diabetes. The incidence and prevalence of both types of lesions are increased in the presence of multimorbidity. The prediction of either type of ulceration is challenging. Current risk assessment practices are reported to be ineffective at predicting when ulceration will occur. While systemic inflammation is easily measured, the presence of local or subclinical inflammation is harder to discern. In patients at risk of either DFUs or PUs, clinical signs and symptoms of inflammation may be masked, and systemic biomarkers of inflammation may not be elevated sufficiently to predict imminent damage until ulceration appears. The current literature suggests that the use of local biomarkers of inflammation at the skin's surface, namely oedema and temperature, may identify early tissue damage.

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Novel Biomarkers Predictive of Diabetic Charcot Foot—An Overview of the Literature

Bobircă

Mușetescu

Bordianu

et al. 2022

Life

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Background: Although Charcot diabetic foot (CDF) is a frequent complication of diabetic neuropathy, less is known about the possibility of its early prevention. Methods: A review of the original articles published in English, using the “biomarkers AND Charcot’s foot” criterion, resulted in 33 articles from the PubMed database and seven articles from the Web of Science database. The five duplicates were eliminated, and two independent reviewers selected the most relevant articles, leaving a total of 21 articles. Results: The biomarkers identified are exhaustively described, related to the system of advanced glycation end products (AGEs) and their soluble receptors (sRAGE), inflammatory cascade, osteoclastogenesis, and, respectively, osteoblastic activity. Conclusions: This article highlights the importance of potential early identifiable biomarkers that can lead to microstructural changes in the affected bones.

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Pathogenesis of Charcot Neuroarthropathy and Acute Management

Cited by 3 publications

References 43 publications

Controversies in the management of active Charcot neuroarthropathy

Controversies in the management of active Charcot neuroarthropathy

Biomarkers of local inflammation at the skin's surface may predict both pressure and diabetic foot ulcers

Novel Biomarkers Predictive of Diabetic Charcot Foot—An Overview of the Literature

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