Diabetic charcot neuroarthropathy: prevalence, demographics and outcome in a regional referral centre

O'Loughlin, Aiden; Kellegher, Edel; McCusker, Christine M.; Canavan, Ronan J.

doi:10.1007/s11845-016-1508-5

Cited by 33 publications

(49 citation statements)

References 9 publications

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“…It would be compatible with Nabarro's estimated cumulative lifetime prevalence of 3 per 1000 from his selected personal series [3]. The recent survey from south-east Ireland was also a loose indication of cumulative incidence in that it combined active and inactive cases over a 7-year period and also suggested a figure of~3 per 1000 [4]. Uncertainty over case selection makes assessment of other reports more difficult, but the cited figures from both Pakistan [5] and in a Hong Kong Chinese population [6] were of the same order.…”

Section: Discussionsupporting

confidence: 71%

Prevalence of active Charcot disease in the East Midlands of England

et al. 2018

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Section: Discussionsupporting

confidence: 71%

Prevalence of active Charcot disease in the East Midlands of England

et al. 2018

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“…CN is an uncommon complication (<0.3 %/year) of diabetes 3. Although the presentation of CN is variable, the most common presentation is sudden onset of unilateral warmth, erythema and oedema of the foot, often with a history of minor trauma, or ulceration as in our patient 4.…”

Section: Discussionmentioning

confidence: 61%

Acute hot foot: Charcot neuroarthropathy or osteomyelitis? Untangling a diagnostic web

Goldsmith¹,

Barlow

Evans

et al. 2019

BMJ Case Rep

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A 55-year-old man with poorly controlled type 1 diabetes with microvascular and macrovascular complications presented with a 1-week history of painful erythematous swelling on the dorsum of the left foot with two areas of foot ulceration. Inflammatory markers were raised. MRI of the left foot revealed a soft tissue swelling on the dorsum of the left foot, marrow oedema and destruction of several small joints of the foot, indicating osteomyelitis and Charcot neuroarthropathy (CN). The soft tissue swelling on the dorsum of the left foot was debrided; per-operatively bone destruction of base of the fifth metatarsal was found. The patient received intravenous antibiotics for 6 weeks. The clinical features of CN including erythema, oedema and elevated temperature of the left foot settled with off-loading the foot in an air cast walker after 6 months. Our case highlights the need to recognise CN in an acutely inflamed foot of diabetic patients with neuropathy, even when other conditions like soft tissue infection and osteomyelitis can explain the clinical features.

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“…11,[21][22][23][24][25]38 In the second group, the study's primary aim was to report outcomes of CN but they may also describe monitoring techniques used, thus providing data to answer our fifth objective on whether monitoring techniques influence outcomes. [6][7][8][9][10][12][13][14][15][16][26][27][28][29][30][31][32][33][34][35][36][37] 3.3 | Techniques used in the monitoring of CN Armstrong et al 38 Level 3…”

Section: Study and Participant Characteristicsmentioning

confidence: 99%

Systematic review of techniques to monitor remission of acute Charcot neuroarthropathy in people with diabetes

Gooday

Gray

Game

et al. 2020

Diabetes Metabolism Res

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Aim: The management of acute Charcot neuroarthropathy relies on off-loading which is costly and time-consuming. Published studies have used monitoring techniques with unknown diagnostic precision to detect remission. We performed a systematic review of techniques for monitoring response to offloading in acute Charcot neuroarthropathy. Materials and Methods: We included studies of off-loading which evaluated or described monitoring techniques in acute Charcot neuroarthropathy. PubMed, EMBASE, CINAHL and Cochrane databases were searched (January1993-July 2018). We extracted data from papers including study design, setting, population, monitoring techniques and treatment outcomes. We also extracted information on the cost, clinical applicability, sensitivity and specificity, safety and participant acceptability of the monitoring techniques. Results: We screened 1205 titles, 140 abstracts and 45 full-texts, and included 29 studies. All studies were of low quality and at high risk of bias. In seven studies, the primary aim was to evaluate monitoring techniques: three evaluated magnetic resonance imaging, two thermography monitoring, one three-phase bone scanning and one Doppler spectrum analysis. The remaining 22 observational studies reported treatment outcomes and described the monitoring techniques used to assess the Charcot neuroarthropathy. Heterogeneity prevented the pooling of data. Very few studies included data on cost, clinical applicability, sensitivity and specificity, safety and patient acceptability of the monitoring techniques used. Conclusion: Multiple techniques have been used to evaluate remission in acute Charcot neuroathropathy but uncertainty remains about their effectiveness. We recommend further research into the influences of different monitoring techniques on treatment outcomes.

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Diabetic charcot neuroarthropathy: prevalence, demographics and outcome in a regional referral centre

Abstract: This is the first prevalence estimate of DCN in Ireland. These data suggest diagnosis of DCN is missed in the acute phase. There exists a significant risk of diabetic foot ulceration and amputation with DCN.

Cited by 33 publications

References 9 publications

Prevalence of active Charcot disease in the East Midlands of England

Prevalence of active Charcot disease in the East Midlands of England

Acute hot foot: Charcot neuroarthropathy or osteomyelitis? Untangling a diagnostic web

Systematic review of techniques to monitor remission of acute Charcot neuroarthropathy in people with diabetes

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