Visualization of local cortical defects in Charcot foot using microcomputed tomography

Senck, Sascha; Plank, Bernhard; Kastner, Johann; Ramadani, F.; Trieb, Klemens; Hofstaetter, Stefan G.

doi:10.1007/s00132-014-3053-0

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…Two severity grades are proposed according to the presence of cortical fracture and two stages (active/inactive) for inflammation signs. Senk et al showed microfractures in early stages of CN of the foot in micro-CT [12]. Scintigraphy and ultrasound have also been used for imaging but there is no classification or typical signs for CN defined [12].…”

Section: Imagingmentioning

confidence: 99%

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A Specific and Reliable Test for Charcot Neuropathy is Still Missing

Illgner¹

2018

BJSTR

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Background: Charcot Neuropathy is a severe complication of patients with neuropathy mostly seen in the foot, but it can also appear in the knee or hand. Not only diabetic patients are involved. CN can lead to a complete collapse of the foot with subsequent ulceration and infection. The mechanism of this episode-like breakdown has not been understood so far. CN still remains mainly a clinical diagnosis depended on clinical experience because there is still no reliable and specific test even though imaging has improved. X-rays represent the traditional way to diagnose CN according to the classification of Eichenholtz of 1967. But at the time these alterations become visible, the bone is already damaged. Therefore Shiabata introduced the MRI as Stage 0 into this existing classification. New approaches using CT or PET/CT have been published.

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Section: Imagingmentioning

confidence: 99%

“…Senk et al showed microfractures in early stages of CN of the foot in micro-CT [12]. Scintigraphy and ultrasound have also been used for imaging but there is no classification or typical signs for CN defined [12]. Using a PET-CT scan to find early inflammation in CN of the foot has been proposed by Ruttolo et al [13].…”

Section: Imagingmentioning

confidence: 99%

A Specific and Reliable Test for Charcot Neuropathy is Still Missing

Illgner¹

2018

BJSTR

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Features of organotopic remodeling of bone tissue and implanted osteoplastic material in Charcot neuro/osteoarthropathy

Osnach,

Protsko,

Kuznetsov

et al. 2023

jour

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Introduction Despite the recognition of MRI as the gold diagnostic standard for Charcot arthropathy, there is evidence in the literature that MSCT is more informative for objective qualitative and quantitative diagnosis of the condition, primarily of the bone skeleton of the Charcot foot, in comparison with standard radiography. The sensitivity and specificity of these methods are different.Purpose To reveal the features of organotopic remodeling of bone tissue and implanted osteoplastic material in the course of midfoot and hindfoot subtotal defects management in Charcot neuro-osteoarthropathy.Materials and methods The analysis of bone tissue and implanted osteoplastic material density was carried out in a case series that included 11 patients with Charcot neuro-osteoarthropathy who underwent a two-stage procedure for bone defects in the hindfoot and midfoot with the Ilizarov apparatus. We studied CT and MRI scans and measured bone regenerate density before treatment, at the stages of transosseous osteosynthesis, and 3, 6, and 12 months after surgery.Results In all patients, varying increase in the amount and volume of bone tissue was visualized due to intensive periosteal bone formation along with the formation of bone ankylosis in the joints along combined with a consistent increase in the optical density of bone regenerates. The formation of the new bone tissue ran without the signs of lysis or sequestration. The conducted studies indicate that the sizes and architectonics of bone fragments are more differentiated in CT than in MRI scans.Discussion It is known that the bone, despite its high mineralization, continuously rebuilds, restores and adapts itself to certain functional conditions. This constant dynamic process of adaptive remodeling depends mostly on optimal blood supply, metabolic activity and the coordinated work of bone cell elements. The data obtained show angiogenesis in the compromised tissues in patients with Charcot foot and consistent remodeling of the graft into the new bone tissue.Conclusion The allobone in the composition of the combined bone graft does not reduce the likelihood of complete remodeling of the newly formed bone tissue. Higher bone density by filling in a bone defect with a graft differs from distraction regenerate that initially has low bone density. CT and MRI are highly effective and informative diagnostic methods for surgical treatment. In reconstructive interventions in the patients with Charcot foot under the conditions of transosseous osteosynthesis, preference among radiological study methods should be given to CT.

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Visualization of local cortical defects in Charcot foot using microcomputed tomography

Abstract: By means of microCT we were able to visualize and quantify the extent of cortical porosity for the first time in high resolution. The data suggest that both cortical fractures and cortical porosity play an important role in the pathogenesis in cases of Charcot foot.

Cited by 2 publications

References 19 publications

A Specific and Reliable Test for Charcot Neuropathy is Still Missing

A Specific and Reliable Test for Charcot Neuropathy is Still Missing

Features of organotopic remodeling of bone tissue and implanted osteoplastic material in Charcot neuro/osteoarthropathy

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