Delayed Diagnosis of Charcot Foot: A Systematic Review

Korst, Genevieve; Ratliff, Hunter T.; Torian, Joseph; Jimoh, Raliat O.; Jupiter, Daniel C.

doi:10.1053/j.jfas.2022.01.008

Cited by 13 publications

(11 citation statements)

References 14 publications

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“…Our study not only sheds light on consequences of delays in the diagnosis of CN, known in the literature to be close to 86.9 days [26], but also provides a description of a chain of management errors with the implementation of care that probably induced the transition of CN from an insipid state to the level of deformity.…”

Section: Discussionmentioning

confidence: 68%

Delayed Diagnosis of Bilateral Neuroarthropathy: Serious Impact on the Development of Charcot’s Foot, a Case Report

et al. 2022

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Charcot neuroarthropathy (CN) is a destructive complication of the joints in patients with diabetes and should be managed from the onset of the first symptoms to avoid joint deformity and the risk of amputating the affected joint. Here, we describe the case of a young 24-year-old patient living with type I diabetes who developed active bilateral CN in both tarsal joints. This case of neuroarthropathy was uncommon due to the bilateral presentation at the same level of the joint. Despite the patient consulting from the beginning of the symptoms, none of the physicians suspected or diagnosed CN, leading to a delay in management and the aggravation of bone destruction by CN. This highlights the importance of early management of CN with the need to refer people with suspected CN to specialised diabetic foot care centres.

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Section: Discussionmentioning

confidence: 68%

Delayed Diagnosis of Bilateral Neuroarthropathy: Serious Impact on the Development of Charcot’s Foot, a Case Report

et al. 2022

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“…Despite the evidence from the literature, a recent metanalysis underlined how to date over 50% experience a delay in diagnosis estimated in 87 days, contributing to consequent worse patient outcomes (namely, major amputations and development of deformities/joint instability requiring surgical correction) [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Early Treatment of Acute Stage 0/1 Diabetic Charcot Foot Can Avoid Major Amputations at One Year

Bittante,

Cerasari,

Bellizzi

et al. 2024

JCM

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Background: If unrecognized, Charcot neuro-osteoarthropathy (CNO) can be a devastating complication of diabetes. Methods: The aim of this retrospective study was to evaluate the outcomes in a cohort of diabetic patients diagnosed with active CNO managed in a tertiary level diabetic foot clinic (DFC). We included consecutive patients with active CNO, stage 0–1, according to the Eichenholtz–Shibata classification, who were referred from 1 January 2019 to 27 September 2022. Diagnosis of CNO was based on clinical signs and imaging (X-rays and magnetic resonance). All patients were completely offloaded by a total-contact cast (TCC) or removable knee-high device. Each patient was closely monitored monthly until CNO remission or another outcome. At 12 months of follow-up, the following outcomes were analyzed: remission, time to remission, major amputations (any above the ankle), and surgical indication. Results: Forty-three patients were included. The mean age was 57.6 ± 10.8 years; 65% were males and 88.4% had type 2 diabetes, with a mean duration of 20.6 ± 9.9 years. At baseline, 32.6% was affected by peripheral artery disease. Complete remission was recorded in 40/43 patients (93%), with a mean time to remission of 5.6 ± 1.5 months; major amputation and surgical indication occurred, respectively in 1/43 patients (2.3%) and 3/43 patients (7%). Conclusions: Early treatment of active Stage 0/1 CNO leads to high rates of remission and limb salvage.

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“… 1 A systematic review by Korst et al in 2022 found similar results; the duration from symptom onset to correct diagnosis was 86.9 days, and 53.2% of cases of CN were initially misdiagnosed. 9 These alarming statistics highlight the challenge in making the diagnosis of CN, which calls attention to the importance of accurate diagnosis and prompt treatment.…”

Section: Patient Case Reportmentioning

confidence: 99%

Charcot Neuroarthropathy of the Foot and Ankle in the Acute Setting: An Illustrative Case Report and Targeted Review

Bagheri,

Anastasio,

Krez

et al. 2023

WestJEM

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Charcot neuroarthropathy (CN) is a rare but serious sequela of diabetes and other diseases that cause peripheral neuropathy. It is most commonly characterized by degeneration of the foot and/or ankle joints leading to progressive deformity and altered weight-bearing. If left untreated, the deformities of CN lead to ulceration, infection, amputation, and even death. Because of the associated peripheral neuropathy and proprioception deficits that accompany CN, patients typically do not perceive the onset of joint destruction. Moreover, in the hands of the untrained clinician, the initial presentation of CN can easily be mistaken for infection, osteoarthritis, gout, or inflammatory arthropathy. Misdiagnosis can lead to the aforementioned serious sequelae of CN. Thus, an early accurate diagnosis and off-loading of the involved extremity, followed by prompt referral to a specialist trained in the care of CN are crucial to prevent the late-term sequelae of the disease. The purpose of this article was to create an opportunity for enhanced understanding between orthopedic surgeons and emergency physicians, to improve patient care through the optimization of diagnosis and early management of CN in the emergent setting.

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Delayed Diagnosis of Charcot Foot: A Systematic Review

Cited by 13 publications

References 14 publications

Delayed Diagnosis of Bilateral Neuroarthropathy: Serious Impact on the Development of Charcot’s Foot, a Case Report

Delayed Diagnosis of Bilateral Neuroarthropathy: Serious Impact on the Development of Charcot’s Foot, a Case Report

Early Treatment of Acute Stage 0/1 Diabetic Charcot Foot Can Avoid Major Amputations at One Year

Charcot Neuroarthropathy of the Foot and Ankle in the Acute Setting: An Illustrative Case Report and Targeted Review

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