The Charcot foot: a pictorial review

Abstract

Charcot foot refers to an inflammatory pedal disease based on polyneuropathy; the detailed pathomechanism of the disease is still unclear. Since the most common cause of polyneuropathy in industrialized countries is diabetes mellitus, the prevalence in this risk group is very high, up to 35%. Patients with Charcot foot typically present in their fifties or sixties and most of them have had diabetes mellitus for at least 10 years. If left untreated, the disease leads to massive foot deformation. This review discusses the typical course of Charcot foot disease including radiographic and MR imaging findings for diagnosis, treatment, and detection of complications.

The “Balgrist Score” for evaluation of Charcot foot: a predictive value for duration of off-loading treatment

“…The most commonly affected region in our study was region III, followed by region II, in which the manifestation demonstrated a higher degree of severity. The lowest manifestation of Charcot disease was seen in region V. This distribution pattern with focus on regions II and III has been reported in studies by Chantelau and Poll [22] and by Sella and Barrette [23] and is also mentioned in reviews [3,4]. We chose a separate evaluation of the parameter "regional manifestation" because this parameter summarizes the severity of clearly Charcot-related changes per region: All other findings that might not be caused by Charcot disease (e.g., bone Soft tissue edema* 0 = none, 1 = mild, 2 = moderate, 3 = severe Bone marrow edema 0 = none, 1 = 0-33%, 2 = 33-66%, 3 = 67-100% Fracture 0 = none, 3 = present Joint destruction 0 = none, 1 = 0-33%, 2 = 33-66%, 3 = 67-100% Total (maximum 24 points) ≥ 90 days off-loading ≥ 9.0 *Example of soft tissue edema classification can be found in the Supplemental Material (Fig.…”

“…The Charcot foot is a potentially devastating complication of patients with peripheral polyneuropathy leading to considerable bone destruction, foot deformity, and risk of pedal ulcer formation [1][2][3][4]. The disease affects the bones, joints, and soft tissues of the foot and ankle.…”

“…These classifications rely on conventional radiographs for disease evaluation. Although magnetic resonance imaging (MRI) has become an essential tool for early disease diagnosis, monitoring of treatment success, and detection of complications, no established MRI-based classification system is currently available [4,[13][14][15]. The two major treatment options for active Charcot foot include early surgical treatment with joint fusions (i.e., arthrodesis) or traditional conservative treatment with off-loading therapy of the affected foot [15].…”

Edema-like marrow signal intensity: a narrative review with a pictorial essay

“…It is important to underline that ELMSI represents a fundamental indicator of a subchondral fracture and a progression towards epiphyseal collapse, which in this case did not occur Neurological Charcot's joint is a progressive degenerative, inflammatory, and destructive joint disease with abnormal pain sensation and proprioception. ELMSI is often associated with this disorder, due to the polyneuropathy caused by diabetes mellitus; the most commonly joints affected are foot and ankle [94]. Even if conventional X-rays acquisitions are traditionally the standard imaging technique for diagnosing, staging, and monitoring the disease, MRI can be very sensitive to obtain an early diagnosis and determine the course of the healing process.…”

Cuidados às pessoas acometidas pela Neuroartropatia de Charcot

“…Frequentemente, o enfermeiro depara-se com essa condição e, como especialista, possui um importante papel na tomada de decisões e de condutas. Para tanto, o reconhecimento e a atuação imediata são as principais chaves para o sucesso no tratamento e somente a ação imediata pode prevenir os danos mais graves, como as amputações (7,9,14,17,(23)(24)(25)(26)(27) A NC pode apresentar-se em duas fases, aguda (ativa) e crônica (inativa) (30,43). Mesmo após décadas de sua relação com o DM, sua fisiopatologia ainda não é bem definida (44).…”