684 results match your criteria Imaging in Neuropathic Arthropathy Charcot Joint


[Diabetic neuropathic osteoarthropathy].

MMW Fortschr Med 2021 06;163(11):65-69

Zentrum für Fuß- und Sprunggelenkschirurgie, Schönklinik München, München, Deutschland.

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MRI-based early diagnosis: a diabetic Charcot spine case report.

BMC Neurol 2021 May 19;21(1):202. Epub 2021 May 19.

Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

Background: Spinal neuroarthropathy (SNA), also known as Charcot spine, is an uncommon aggressive arthropathy, secondary to loss of proprioceptive and nociceptive feedback from the spine. A diagnosis of SNA is frequently delayed due to the scarcity of symptoms in its early stages, leading to significant neurological deterioration. Therefore, prompt suspicion of the disease is critical to providing better outcomes. Read More

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[50/m-Nonhealing Charcot foot with a fistula : Preparation for the medical specialist examination: case 63].

Orthopade 2021 04 25;50(Suppl 1):175-180. Epub 2021 Feb 25.

Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland.

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Are the Sanders-Frykberg and Brodsky-Trepman Classifications Reliable in Diabetic Charcot Neuroarthropathy?

J Foot Ankle Surg 2021 May-Jun;60(3):432-435. Epub 2021 Feb 3.

Professor, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX; Professor, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.

The purpose of this study was to assess the intra- and inter-reader reliability of the 2 Charcot neuroarthropathy classifications (Sanders-Frykberg and Brodsky-Trepman), as well as Eichenholtz staging. We hypothesized that the inter-reader reliability, with respect to these 3 classification systems, would be moderate at best. Digital radiographic images were organized in a digital slide presentation without clinical information. Read More

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A Systematic Review of Angular Deformities in Charcot Neuroarthropathy.

J Foot Ankle Surg 2021 Mar-Apr;60(2):368-373. Epub 2020 Oct 7.

Professor and Attending Physician, Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address:

Charcot neuroarthropathy of the foot and ankle is associated with periarticular deformities and progressive radiographic changes. There have been studies analyzing the radiographic angulations and deformity progression in Charcot neuroarthropathy deformity. The aim of this paper is to provide systematic review of studies that evaluate foot and ankle radiographic parameters in patients with Charcot neuroarthropathy. Read More

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Midfoot Charcot Neuro-arthropathy Precipitated by First or Fifth ray Amputation.

Foot Ankle Surg 2020 Oct 11. Epub 2020 Oct 11.

Trauma and Orthopaedics Department, Sheffield Teaching Hospitals NHS Trust, Herries Rd, Sheffield S5 7AU, UK.

Background: Charcot Neuro-arthropathy (CN) can occur spontaneously in a neuropathic foot but is often precipitated by an insult to the foot, such as trauma. We noted an association between 1st and 5th ray amputations and the development of midfoot CN in our clinics. We therefore set out to analyse our data over a 6-year period to evaluate and improve our practice. Read More

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October 2020

Neuropathic Arthropathy of a Knee Joint: A Case Report.

Isr Med Assoc J 2020 10;22(10):650-651

Shine Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel.

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October 2020

Charcot Midfoot Reconstruction: Does Subtalar Arthrodesis or Medial Column Fixation Improve Outcomes?

J Foot Ankle Surg 2020 Nov - Dec;59(6):1219-1223. Epub 2020 Jul 18.

Assistant Professor, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address:

Charcot neuroarthropathy is a complication of neuropathy often secondary to diabetes mellitus and most commonly affects the midfoot. In these patients, reconstruction of the foot may be required for limb salvage. A superconstruct technique has previously been described using intramedullary beaming fixation of the midfoot and hindfoot to span the zone of injury. Read More

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The "Balgrist Score" for evaluation of Charcot foot: a predictive value for duration of off-loading treatment.

Skeletal Radiol 2021 Feb 23;50(2):311-320. Epub 2020 Jul 23.

Faculty of Medicine, University of Zurich, Zurich, Switzerland.

Objective: To develop a new magnetic resonance imaging(MRI) scoring system for evaluation of active Charcot foot and to correlate the score with a duration of off-loading treatment ≥ 90 days.

Methods: An outpatient clinic database was searched retrospectively for MRIs of patients with active Charcot foot who completed off-loading treatment. Images were assessed by two radiologists (readers 1 and 2) and an orthopedic surgeon (reader 3). Read More

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February 2021

Is Reconstruction of Unstable Midfoot Charcot Neuroarthropathy Cost Effective from a US Payer's Perspective?

Clin Orthop Relat Res 2020 Dec;478(12):2869-2888

R. H. Albright, The Dartmouth Institute, Geisel School of Medicine, Hanover, NH, USA.

Background: Charcot neuroarthropathy is a morbid and expensive complication of diabetes that can lead to lower extremity amputation. Current treatment of unstable midfoot deformity includes lifetime limb bracing, primary transtibial amputation, or surgical reconstruction of the deformity. In the absence of a widely adopted treatment algorithm, the decision to pursue more costly attempts at reconstruction in the United States continues to be driven by surgeon preference. Read More

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December 2020

Increased Risk of Nonunion and Charcot Arthropathy After Ankle Fracture in People With Diabetes.

J Foot Ankle Surg 2020 Jul - Aug;59(4):653-656

Professor, Department of Orthopedic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX.

The aim of this study was to evaluate the frequency of complications after an ankle fracture in patients with and without diabetes and to evaluate risk factors for nonunion. We conducted a retrospective study of 439 patients with ankle fractures (31.7% had diabetes) and followed them for 1 year or until the fracture healed. Read More

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Cerebrospinal fluid-cutaneous fistula associated with post-traumatic Charcot spinal arthropathy: a case report and review of literature.

BMC Musculoskelet Disord 2020 Jun 29;21(1):412. Epub 2020 Jun 29.

Department of Orthopaedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 63-ro 10 Yeongdeungpo-gu, Seoul, 07345, South Korea.

Background: Charcot spinal arthropathy, also known as Charcot spine and neuropathic spinal arthropathy, is a progressive and destructive condition that affects an intervertebral disc and the adjacent vertebral bodies following loss of spinal joint innervation. We report the first case of Charcot spinal arthropathy (CSA) associated with cerebrospinal fluid (CSF)-cutaneous fistula.

Case Presentation: A 54-year-old male who underwent T10-L2 posterior instrumented spinal fusion seven years prior for treatment of T11 burst fracture and accompanying T11 complete paraplegia visited our department complaining of leakage of clear fluid at his lower back. Read More

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Ultrasonographic features of acute Charcot neuroarthropathy of the foot: a pilot study.

Clin Rheumatol 2020 Dec 24;39(12):3787-3793. Epub 2020 May 24.

Rheumatology & Rehabilitation Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Objectives: Our aim was to characterize the ultrasonographic features of patients with acute Charcot neuroarthropathy (CN) of the foot.

Methods: In this prospective study, 26 patients with CN of the foot proved by MRI were enrolled. All patients were in early stage of CN with normal radiography (grade 0 modified Eichenholtz classification system). Read More

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December 2020

Treatment of Ankle and Hindfoot Charcot Arthropathy.

Authors:
Michael S Pinzur

Foot Ankle Clin 2020 Jun;25(2):293-303

Loyola University Health System, 2160 South First Avenue, Maywood, IL 60153, USA. Electronic address:

It is now well accepted that diabetic patients with clinically and radiographically nonplantigrade Charcot foot arthropathy are best managed with correction of the acquired deformity. Several investigations have demonstrated a high probability for a favorable clinical outcome when the deformity is in the midfoot. Unstable deformity at the subtalar or ankle joints portends a far worse clinical outcome. Read More

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Charcot Neuroarthropathy and a New Sign: "Soft Tissue Contamination Sign of Foot or Ankle" on Bolus Chase 3-Dimensional Magnetic Resonance Imaging.

J Foot Ankle Surg 2020 May - Jun;59(3):643-644

Professor, Department of Diagnostic and Interventional Radiology, Adnan Menderes University, Aydın, Turkey.

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February 2021

Internal Amputation in Charcot Neuroarthropathy Complicated by Diabetic Foot Osteomyelitis.

J Foot Ankle Surg 2020 Jul - Aug;59(4):853-856. Epub 2020 Apr 9.

Member, Ohio Innovations Group, Columbus, OH; Director, FASCO Reconstructive Foot & Ankle Surgery Fellowship, Columbus, OH; Chairman, Podiatric Medicine & Surgery, Grant Medical Center, Columbus, OH.

Studies have demonstrated the importance of preserving plantar surface area, lever arm length, and plantar soft tissues in affording patients a plantigrade, stable, and functional limb. We describe a case of a patient who underwent internal pedal amputation that was amenable to functional bracing. The purpose of this case study is to present internal pedal amputation as a viable option to eradicate infection and produce a plantigrade, stable foot that is amenable to custom bracing. Read More

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Closed arthrodesis in infected neuropathic ankles using Ilizarov ring fixation.

Bone Joint J 2020 Apr;102-B(4):470-477

Purulent Osteology Clinic, Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics, Kurgan, Russia.

Aims: Infected and deformed neuropathic feet and ankles are serious challenges for surgical management. In this study we present our experience in performing ankle arthrodesis in a closed manner, without surgical preparation of the joint surfaces by cartilaginous debridement, but instead using an Ilizarov ring fixator (IRF) for deformity correction and facilitating fusion, in arthritic neuropathic ankles with associated osteomyelitis.

Methods: We retrospectively reviewed all the patients who underwent closed ankle arthrodesis (CAA) in Ilizarov Scientific Centre from 2013 to 2018 (Group A) and compared them with a similar group of patients (Group B) who underwent open ankle arthrodesis (OAA). Read More

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Computer-Assisted Gradual Correction of Charcot Foot Deformities: An In-Depth Evaluation of Stage One of a Planned Two-Stage Approach to Charcot Reconstruction.

J Foot Ankle Surg 2020 Jul - Aug;59(4):841-848. Epub 2020 Mar 5.

Student, University of California, San Diego, La Jolla, CA.

The surgical treatment of Charcot foot is a widely debated topic, with issues ranging from when to operate to how to properly correct a deformity. Historically, correction of a severe deformity was attempted in 1 acute surgical procedure that frequently required open reduction and internal fixation through large incisions. This 1-time procedure would often result in complications including under- or overcorrection of the deformity, neurovascular injury, or incision dehiscence leading to possible soft-tissue infection or osteomyelitis. Read More

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Two Cases of Periprosthetic Fracture After Surgery for Acute Midfoot Charcot.

J Foot Ankle Surg 2020 Mar - Apr;59(2):394-398

Surgeon, Section for Foot and Ankle Surgery, Department of Orthopaedic Surgery, Oslo University Hospital Ullevål, Oslo, Norway.

Charcot neuroarthropathy is a rare condition that often results in deformity of the foot and ankle, with a high incidence of ulceration and a high risk of amputation. Traditionally, treatment of the acute stages of Charcot foot has been nonoperative until consolidation. Still, a large number of patients develop deformities, and early operative treatment of unstable Charcot feet has been suggested. Read More

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January 2021

A radiological severity scale to measure the impact of Charcot's Neuroarthropathy: an observational study.

J Foot Ankle Res 2020 Feb 11;13(1). Epub 2020 Feb 11.

Monash Health, Allied Health Research Unit, Warrigal Rd, Cheltenham, VIC, 3192, Australia.

Background: Charcot's Neuroarthropathy (Charcot foot) is a debilitating and destructive disorder resulting from neurological changes in the foot. Whilst the majority of cases are painless, as a result of disruption to sensory function, a common outcome is severe deformity that impacts considerably on foot function. The purpose of this study was to develop and validate a radiological severity scale to quantify resultant damage from acute mid foot Charcot's. Read More

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February 2020

[Diagnosis and treatment of Charcot's osteoarthropathy].

Zhongguo Gu Shang 2019 Dec;32(12):1168-1172

Department of Orthopaedics, Tangshan Branch of Nanjing General Hospital, Nanjing 211131, Jiangsu, China;

Charcot foot is a rare disease in clinic, its pathogenesis includes neurotrauma theory, neurovascular theory, comprehensive theory, and inflammatory factor theory. The disease is characterized by progressive joint and bone destruction of foot and ankle joint. Conventional X-ray examination is not sensitive to the early diagnosis of disease, the manifestation of CT and MRI of disease is characteristic and could be used to make a comprehensive evaluation of bone and soft tissue lesions of disease. Read More

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December 2019

Results of Simple Conservative Treatment of Midfoot Charcot Arthropathy.

Clin Orthop Surg 2019 Dec 12;11(4):459-465. Epub 2019 Nov 12.

Department of Orthopedic and Traumatology, Foot and Ankle, Musculoskeletal Clinic, Fatmawati General Hospital, Jakarta, Indonesia.

Background: Traditionally, conservative management with an offloading orthosis, such as total contact cast (TCC), has been the standard of care for midfoot Charcot arthropathy. Considering complications of TCC and surgery, we treated midfoot Charcot arthropathy without TCC in our patients. The purpose of this study was to report clinical and radiological outcomes of conservative management of midfoot Charcot arthropathy. Read More

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December 2019

ACR Appropriateness Criteria® Suspected Osteomyelitis of the Foot in Patients With Diabetes Mellitus.

J Am Coll Radiol 2019 Nov;16(11S):S440-S450

Specialty Chair, Mayo Clinic, Jacksonville, Florida.

Diabetes-related foot complications such as soft-tissue infection, osteomyelitis, and neuropathic osteoarthropathy account for up to 20% of all diabetic-related North American hospital admissions. Radiography of the foot is usually appropriate as the initial screening examination in diabetic patients with suspected osteomyelitis of the foot. For follow-up examination, MRI of the foot with or without contrast enhancement demonstrates excellent soft-tissue contrast and sensitivity to marrow abnormalities with high-resolution detail in multiple anatomic planes and is usually appropriate when osteomyelitis or early neuropathic arthropathy is suspected. Read More

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November 2019

Neuropathic Arthropathy of the Shoulder: A Systematic Review of Classifications and Treatments.

JBJS Rev 2019 10;7(10):e1

University of Central Florida College of Medicine, Orlando, Florida.

Background: Neuropathic arthropathy of the shoulder is a chronic progressive process characterized by joint destruction in the presence of a neurosensory deficit. Causes include syringomyelia, syphilis, diabetes, chronic alcoholism, and leprosy, with syringomyelia accounting for the vast majority of upper-extremity Charcot joints. Early presentation of this rare condition includes nonspecific symptoms such as swelling, erythema, sensory symptoms, and decreased functionality, making diagnosis challenging. Read More

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October 2019

Surgical management of a complex case of Charcot arthropathy of the spine: a case report.

Spinal Cord Ser Cases 2019 22;5:73. Epub 2019 Aug 22.

Department of Neurological Surgery, The George Washington University Hospital, The George Washington University School of Medicine and Health Sciences, Washington, DC, WA 20037 United States.

Introduction: The authors present a case of a 55-year-old male with T10 complete paraplegia diagnosed with Charcot arthropathy of the spine (CAS).

Case Presentation: He presented to an outside institution with vomiting and productive cough with subsequent computed tomography (CT) and MRI imaging revealing L5 osteomyelitis and a paraspinal abscess. Given the patient's inability to remain in good posture in his wheelchair he underwent a multilevel vertebrectomy and thoracolumbar fusion. Read More

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A high-profile thread with grit-blasted and acid-etched surface reduces loosening of medial column fusion bolt in instable Charcot foot.

Foot Ankle Surg 2020 Aug 22;26(6):637-643. Epub 2019 Aug 22.

Center of Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany.

Background: Intramedullary fusion bolts (FB) were introduced to stabilize the medial column of the instable Charcot foot (ICF), but complications as bolt loosening or breakage are frequent. We compared the use of a standard FB and a high-profile threaded FB with a grit-blasted surface. We hypothesized that implant related complications occurred less often and osseous consolidation of fusion sites was more distinctive using the latter type of FB. Read More

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Plantar Approach for Midfoot Wedge Resection to Reconstruct the Rocker Bottom Foot.

J Foot Ankle Surg 2019 Sep;58(5):1030-1035

Assistant Professor, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA; Director, Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA; Chief, Podiatry Section, University of Pittsburgh Medical Center Mercy Hospital, Pittsburgh, PA.

Chronic deformity of the foot can lead to ulceration, infection, and amputation. Midfoot wedge osteotomy for deformity correction has been described in the literature; however, most reports are case review or small series. Wedge osteotomy can be performed from a medial or plantar approach, but there are limited data on outcomes regarding these relatively uncommon procedures. Read More

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September 2019

Charcot Neuroarthropathy Advances: Understanding Pathogenesis and Medical and Surgical Management.

Clin Podiatr Med Surg 2019 Oct;36(4):663-684

Podiatry, Mercy Health Regional Medical Center, 3700 Kolbe Road, Lorain, OH 44053, USA.

Understanding new theories of the epidemiology of Charcot neuroarthropathy is practice changing. Treatment of Charcot neuroarthropathy is evolving from a passive approach to one that sees the urgency of proactive, early recognition, thereby avoiding the cascading events that lead to the complex, limb-threatening deformities. Preventive medicine is the most efficient at avoiding severe deformity, with prolonged offloading and immobilization as the current mainstay of treatment. Read More

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October 2019

The many facets of neuropathic arthropathy.

BJR Open 2019 29;1(1):20180039. Epub 2019 Jul 29.

Princess Margaret Hospital, Department of Radiology, Hong Kong.

Neuropathic arthropathy, also known as Charcot arthropathy, refers to progressive and occasionally rapid joint destruction that results from underlying disorders of the nervous system. This pictorial essay aims to illustrate various radiologic findings in neuropathic arthropathy using various examples in the upper and lower limbs and in the spine. Pearls for radiologic diagnosis, clinical differential considerations and possible complications are discussed individually for each joint. Read More

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