Diagnostic delays in diabetic Charcot arthropathy

Gill, GV; Hayat, Humera; Majid, S

doi:10.1002/pdi.677

Cited by 10 publications

(8 citation statements)

References 6 publications

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“…The clinical picture of Charcot arthropathy, particularly in the acute phase, is non-specific, and results in a considerable delay of diagnosis in even 25% of cases, which significantly affects final treatment outcomes ( 30 ) . The differentiation of the nature of abnormalities requires combined assessment of the clinical picture and the results of additional tests.…”

Section: Neurogenic Arthropathymentioning

confidence: 99%

Diabetic foot syndrome: Charcot arthropathy or osteomyelitis? Part I: Clinical picture and radiography

et al. 2018

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One of significant challenges faced by diabetologists, surgeons and orthopedists who care for patients with diabetic foot syndrome is early diagnosis and differentiation of bone structure abnormalities typical of these patients, i.e. osteitis and Charcot arthropathy. In addition to clinical examination, the patient’s medical history and laboratory tests, imaging plays a significant role. The evaluation usually begins with conventional radiographs. In the case of osteomyelitis, radiography shows osteopenia, lytic lesions, cortical destruction, periosteal reactions as well as, in the chronic phase, osteosclerosis and sequestra. Neurogenic arthropathy, however, presents an image resembling rapidly progressing osteoarthritis combined with aseptic necrosis or inflammation. The image includes: bone destruction with subluxations and dislocations as well as pathological fractures that lead to the presence of bone debris, osteopenia and, in the later phase, osteosclerosis, joint space narrowing, periosteal reactions, grotesque osteophytes and bone ankylosis. In the case of an unfavorable course of the disease and improper or delayed treatment, progression of these changes may lead to significant foot deformity that might resemble a “bag of bones”. Unfortunately, radiography is non-specific and frequently does not warrant an unambiguous diagnosis, particularly in the initial phase preceding bone destruction. For these reasons, alternative imaging methods, such as magnetic resonance tomography, scintigraphy, computed tomography and ultrasonography, are also indicated.

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Section: Neurogenic Arthropathymentioning

confidence: 99%

Diabetic foot syndrome: Charcot arthropathy or osteomyelitis? Part I: Clinical picture and radiography

et al. 2018

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“…Next, 533 full‐text articles were assessed for eligibility and 71 were included for data extraction (Fig. ) . Nine papers were foreign‐language texts: six French, two Spanish and one Turkish.…”

Section: Resultsmentioning

confidence: 99%

The red leg dilemma: a scoping review of the challenges of diagnosing lower‐limb cellulitis

et al. 2018

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“…There are also many published case reports, such as those by Arnold and McGowan [18] and Gill et al . [19]—but unusual cases do not constitute the evidence required to inform the implementation of patient safety systems.…”

Section: Discussionmentioning

confidence: 99%

“…There is a wide literature on the primary care of people with diabetes that has no explicit mention of the prevention of medical error. There are also many published case reports, such as those by Arnold and McGowan [18] and Gill et al [19]-but unusual cases do not constitute the evidence required to inform the implementation of patient safety systems.…”

Section: Limitations and Strengthsmentioning

confidence: 99%

Patient safety systems in the primary health care of diabetes—a story of missed opportunities?

et al. 2010

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There is very little evidence on how patient safety systems for the management of primary care diabetes can be implemented, or on how the effectiveness of such systems can be maximized. If patient safety systems do have potential to improve the processes and outcomes of care, the lack of relevant research may be regarded as a missed opportunity—investigation into the reasons for the situation is needed, with the aim of motivating and enabling further research on a range of problems identified here.

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Diagnostic delays in diabetic Charcot arthropathy

Cited by 10 publications

References 6 publications

Diabetic foot syndrome: Charcot arthropathy or osteomyelitis? Part I: Clinical picture and radiography

Diabetic foot syndrome: Charcot arthropathy or osteomyelitis? Part I: Clinical picture and radiography

The red leg dilemma: a scoping review of the challenges of diagnosing lower‐limb cellulitis

Patient safety systems in the primary health care of diabetes—a story of missed opportunities?

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