Diagnosis and treatment of Charcot's osteoarthropathy.
10.3969/j.issn.1003-0034.2019.12.021
- Author:
Guo-Liang LIU
1
;
Bin-Kui YANG
1
;
Hong-Ran DONG
2
,
3
Author Information
1. Department of Orthopaedics, Tangshan Branch of Nanjing General Hospital, Nanjing 211131, Jiangsu, China.
2. Department of Orthopaedics, Tangshan Branch of Nanjing General Hospital, Nanjing 211131, Jiangsu, China
3. 1405dhr@sohu.com.
- Publication Type:Journal Article
- Keywords:
Foot joints;
Review;
Therapy
- MeSH:
Amputation;
Ankle Joint;
Arthropathy, Neurogenic;
Diabetic Foot;
Humans;
Radiography
- From:
China Journal of Orthopaedics and Traumatology
2019;32(12):1168-1172
- CountryChina
- Language:Chinese
-
Abstract:
Charcot foot is a rare disease in clinic, its pathogenesis includes neurotrauma theory, neurovascular theory, comprehensive theory, and inflammatory factor theory. The disease is characterized by progressive joint and bone destruction of foot and ankle joint. Conventional X-ray examination is not sensitive to the early diagnosis of disease, the manifestation of CT and MRI of disease is characteristic and could be used to make a comprehensive evaluation of bone and soft tissue lesions of disease. It is not difficult to make a diagnosis based on characteristic findings of CT and MRI and clinical manifestations such as swelling, pain and skin temperature rising of foot and ankle. Charcot foot has multiple classification methods including anatomy, imaging and clinical classification. Improved Eichenholtz staging classification is most commonly used currently which could make a more comprehensive assessment of disease and guide treatment better. According to the stage of disease, treatment could be carried out including non-weight bearing and brace protection, drugs therapy and surgical treatment, etc. Early diagnosis, brace protection, could protect joint and delaying progression of deformity. There is no clear long-term and generally accepted conclusion about the efficacy of drug therapy. For advanced patients, surgical treatment must be actively performed to preserve a stable and functional ankle joint and reduce amputation rate.
