Current Concepts In Treating Acute Charcot's Arthropathy

Start Page: 16
Here is a preoperative weightbearing lateral radiograph that shows typical Charcot changes. Note the equinus deformity with midfoot plantar prominence and severe destruction of the tarsometatarsal joint.
Here one can see a histopathology slide (decalcified H&E) for the same patient that is taken from the resected bone surrounding the tarsometatarsal joint during arthrodesis. Note the thin, sparse trabeculae and widened marrow spaces.
Current Concepts In Treating Acute Charcot's Arthropathy
20
Author(s): 
By Lee C. Rogers, DPM, Nicholas J. Bevilacqua, DPM, and David G. Armstrong, DPM, PhD

1. Tan AL, Greenstein A, Jarrett SJ, McGonagle D. Acute neuropathic joint disease: a medical emergency? Diabetes Care. Dec 2005;28(12):2962-2964.
2. Chantelau E. The perils of procrastination: effects of early vs. delayed detection and treatment of incipient Charcot fracture. Diabet Med. Dec 2005;22(12):1707-1712.
3. Pakarinen TK, Laine HJ, Honkonen SE, Peltonen J, Oksala H, Lahtela J. Charcot arthropathy of the diabetic foot. Current concepts and review of 36 cases. Scand J Surg. 2002;91(2):195-201.
4. Khanna D, Arnold EL, Pencharz JN, et al. Measuring process of arthritis care: the Arthritis Foundation's quality indicator set for rheumatoid arthritis. Semin Arthritis Rheum. Feb 2006;35(4):211-237.
5. Stevens MJ, Edmonds ME, Foster AV, Watkins PJ. Selective neuropathy and preserved vascular responses in the diabetic Charcot foot. Diabetologia. Feb 1992;35(2):148-154.
6. Armstrong DG, Lavery LA. Monitoring healing of acute Charcot's arthropathy with infrared dermal thermometry. J Rehab Res Dev. 1997;34(3):317-321.
7. Jirkovska A, Kasalicky P, Boucek P, Hosova J, Skibova J. Calcaneal ultrasonometry in patients with Charcot osteoarthropathy and its relationship with densitometry in the lumbar spine and femoral neck and with markers of bone turnover. Diabet Med. Jun 2001;18(6):495-500.
8. Petrova NL, Foster AV, Edmonds ME. Calcaneal bone mineral density in patients with Charcot neuropathic osteoarthropathy: differences between Type 1 and Type 2 diabetes. Diabet Med. Jun 2005;22(6):756-761.
9. Jeffcoate W. Vascular calcification and osteolysis in diabetic neuropathy - is RANK-L the missing link? Diabetologia. 2004;47:1488-1492.
10. Armstrong DG, Todd WF, Lavery LA, Harkless LB, Bushman TR. The natural history of acute Charcot's arthropathy in a diabetic foot specialty clinic. J Am Podiatr Med Assoc. Jun 1997;87(6):272-278.
11. McCrory JL, Morag E, Norkitis AJ, al. E. Healing of Charcot fractures: skin temperature and radiographic correlates. Foot. 1998;8:158-162.
12. Morgan JM, Biehl WC, 3rd, Wagner FW, Jr. Management of neuropathic arthropathy with the Charcot Restraint Orthotic Walker. Clin Orthop Relat Res. Nov 1993(296):58-63.
13. Jude EB, Boulton AJ. Medical treatment of Charcot’s arthropathy. J Am Podiatr Med Assoc. Jul-Aug 2002;92(7):381-383.
14. Trepman E, Nihal A, Pinzur MS. Current topics review: Charcot neuroarthropathy of the foot and ankle. Foot Ankle Int. Jan 2005;26(1):46-63.
15. Jeffcoate WJ, Game F, Cavanagh PR. The role of proinflammatory cytokines in the cause of neuropathic osteoarthropathy (acute Charcot foot) in diabetes. Lancet. Dec 10 2005;366(9502):2058-2061.
16. Evans BE, Chaturvedi N, Haskard DO, Landis RC. Persistent tumor necrosis factor (TNF) A synthesis during cutaneous inflammation in persons with diabetes. Paper presented at: American Diabetes Association Annual Scientific Sessions, 2006; Washington, D.C.
17. Jarvinen TA, Jarvinen TL, Kaariainen M, Kalimo H, Jarvinen M. Muscle injuries: biology and treatment. Am J Sports Med. May 2005;33(5):745-764.
18. Armstrong DG, Sangalang MB, Jolley D, et al. Cooling the foot to prevent diabetic foot wounds: a proof-of-concept trial. J Am Podiatr Med Assoc. Mar-Apr 2005;95(2):103-107.
19. Jude EB, Selby PL, Burgess J, et al. Bisphosphonates in the treatment of Charcot neuroarthropathy: a double-blind randomised controlled trial. Diabetologia. Nov 2001;44(11):2032-2037.
20. Pitocco D, Ruotolo V, Caputo S, et al. Six-month treatment with alendronate in acute Charcot neuroarthropathy: a randomized controlled trial. Diabetes Care. May 2005;28(5):1214-1215.
21. Rogers MJ. New insights into the molecular mechanism of action of bisphosphonate. Curr Pharm Des. 2003;9:2643-2658.
22. Bem R, Jirkovska A, Fejfarova V, Skibova J, Jude EB. Intranasal calcitonin in the treatment of acute Charcot neuroosteoarthropathy: a randomized controlled trial. Diabetes Care. Jun 2006;29(6):1392-1394.
23. Strauss E, Gonya G. Adjunct low intensity ultrasound in Charcot neuroarthropathy. Clin Orthop Relat Res. Apr 1998(349):132-138.
24. Hanft JR, Goggin JP, Landsman A, Surprenant M. The role of combined magnetic field bone growth stimulation as an adjunct in the treatment of neuroarthropathy/Charcot joint: an expanded pilot study. J Foot Ankle Surg. Nov-Dec 1998;37(6):510-515; discussion 550-511.
25. Petrisor B, Lau JT.

image description image description


Post new comment

  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

More information about formatting options

Image CAPTCHA
Enter the characters shown in the image.