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

Abstract

The lower calcaneal QUS parameter stiffness in the Charcot foot in comparison with the control group, with the non-Charcot foot and with BMD in the lumbar spine and femoral neck, and its association with increased bone resorption indicate that calcaneal ultrasonometry may be useful in diagnosing the acute stage of CO and in assessing the risk of foot fracture. Diabet. Med. 18, 495-500 (2001)

Osteomyelitis or Charcot neuro-osteoarthropathy? Differentiating these disorders in diabetic patients with a foot problem

“…In one study, levels of bone-specific alkaline phosphatase (a marker of bone formation) and urinary deoxypyridinoline (a marker of bone resorption) were found to be increased in acute CN compared to diabetic persons without CN, reflecting ongoing bone turnover and remodelling (50). Two other studies found an increase in the bone resorption marker pyridinoline cross-linked carboxy-terminal telopeptide domain of type 1 collagen in acute CN (51, 52). Preliminary reports suggest, however, that conventional markers of bone turnover are of no value in differentiating osteomyelitis from Charcot arthropathy (53).…”

Update on charcot neuroarthropathy

“…Only one study has demonstrated, in a small group of patients presenting with a hot swollen foot, that reduced bone mineral density (using bone densitometry) in the lower limb led to the subsequent development of Charcot foot compared to patients with higher bone mineral density at baseline [21]. Using broadband ultrasound, attenuation studies have also shown a reduction in bone density in the calcaneus in patients with CNA [22,23]. The latter study also showed an increase in 1CTP in patients with acute CNA and a direct correlation between plasma 1CTP and bone density in the calcaneus.…”

Pathogenesis and Medical Management of Diabetic Charcot Neuroarthropathy

“…In such instances, dualenergy x-ray absorptiometry can detect a diminished BMD in high-risk diabetic patients. 32 An MRI is efficient in detecting trivial changes, such as bone edema or microfractures, during the early stages of CN and this correlates with signs of CN. 33 Diabetic Charcot Neuroarthropathy…”