The authors declare that they have no competing interests.
BBY designed and conducted the study, AS wrote the manuscript, SK collected the data, RA edited and helped in manuscript writing, and JM reviewed the manuscript and helped in statistical analysis.
Charcot osteoarthropathy or charcot foot is a rare, chronic, non-communicable condition of bones and joints which may results into severe deformity and more prone to develop ulcers possibly leading to amputation. The purpose of this study was to determine the prevalence of Charcot osteoarthropathy and its association with age, BMI, gender, duration of diabetes, HBA1c and peripheral neuropathy.
A total of 1931 subjects with type 2 diabetes having mean age 50.72 ± 10.66 years presenting in a specialist diabetes clinic at shalamar hospital, Lahore, Pakistan were enrolled. The diagnosis of Charcot osteoarthropathy was made by examination of both dorsal and plantar surfaces of foot for swelling, erythema, increase in temperature and any musculoskeletal deformity which was later confirmed by radiographs. Assessment of neuropathy was carried out by checking the sense of pressure, joint position and vibration. BMI (Body Mass Index), fasting blood glucose (FBG) and HbA1C were determined.
In all subjects including male 704 (36.45 %) and female 1227 (63.55 %), 0.4 % subjects had charcot deformity, while 0.2 %, 0.15 % and 0.05 % subjects having right, left and bilateral deformity respectively. Bilaterally symmetrical neuropathy was diagnosed in 25.4 % in subjects. There was a significant association (p < 0.05) of deformity with duration of diabetes, HbA1C and neuropathy, however no significant association (p > 0.05) was found with age, BMI, weight, height and gender.
There is a need to have a special care of persons with diabetes regarding blood glucose control and development of peripheral neuropathy. Early identification and management of risk factors may prevent the occurrence of charcot deformity. Patients must be educated about the foot care.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.Diabetes Care May 2004 27:5 1047-1053; doi:10.2337/diacare.27.5.1047.
International Diabetes Federation,IDF Diabetes Atlas. In: 6th edn edn. Brussels, Belgium: International Diabetes Federation; 2013.
Ergen FB, Sanverdi SE, Oznur A. Charcot foot in diabetes and an update on imaging. Diabet Foot Ankle. 2013;4.
Rogers LC, Frykberg RG, Armstrong DG, Boulton AJ, Edmonds M, Van GH, et al. The Charcot foot in diabetes. Diabet Care. 2011;34(9):2123–9. CrossRef
Samann A, Pofahl S, Lehmann T, Voigt B, Victor S, Moller F, et al. Diabetic nephropathy but not HbA1c is predictive for frequent complications of Charcot feet - long-term follow-up of 164 consecutive patients with 195 acute Charcot feet. Exp Clin Endocrinol Diabetes. 2012;120(6):335–9. CrossRefPubMed
Pakarinen TK, Laine HJ, Honkonen SE, Peltonen J, Oksala H, Lahtela J. Charcot arthropathy of the diabetic foot. Current concepts and review of 36 cases. Scand J Surg. 2002;91(2):195–201. PubMed
Boulton AJ, Armstrong DG, Albert SF, Frykberg RG, Hellman R, Kirkman MS, et al. Comprehensive Foot Examination and Risk Assessment A report of the Task Force of the Foot Care Interest Group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabet Care. 2008;31(8):1679–85. CrossRef
Uccioli L, Sinistro A, Almerighi C, Ciaprini C, Cavazza A, Giurato L, et al. Proinflammatory modulation of the surface and cytokine phenotype of monocytes in patients with acute Charcot foot. Diabet Care. 2010;33(2):350–5. CrossRef
Larson SA, Burns PR. The pathogenesis of Charcot neuroarthropathy: current concepts. Diabet Foot Ankle. 2012;3.
Chen H-W, Su D-H, Chuang L-M, Wang C-Y, Chen H-W, Tai T-Y. Neuropathic Osteoarthropathy (Charcot’s Foot) as a Chronic Complication of Diabetes—A Case Report. Tzu Chi Med J. 2005;17(4):287–90.
Perrin BM, Gardner MJ, Suhaimi A, Murphy D. Charcot osteoarthropathy of the foot. Aust Fam Physician. 2010;39(3):117–9. PubMed
Leung HB, Ho YC, Wong WC. Charcot foot in a Hong Kong Chinese diabetic population. Hong Kong Med J. 2009;15(3):191–5. PubMed
Johnson T. Charcot’s osteoarthropathy: An increased awareness of this condition may help in enabling an earlier diagnosis, instituting appropriate treatment, and preventing severe deformity and disability. Cont Med Educ. 2010;28(4):171–5.
- Charcot osteoarthropathy in type 2 diabetes persons presenting to specialist diabetes clinic at a tertiary care hospital
Bilal Bin Younis
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II