1/29. Neuropathic arthropathy of the elbow. A report of five cases.BACKGROUND: Neuropathic arthropathy of the elbow is rare and characterized by a painless but unstable articulation. The functional capacity of patients with this condition has not been reviewed in detail. methods: Five male patients, with an average age of fifty-one years, were treated for neuropathic arthropathy of the elbow. The underlying conditions associated with the arthropathy included syringomyelia, insulin-dependent diabetes mellitus, end-stage renal failure, and two cases of polyneuropathy of unknown cause. Four patients sought medical attention after a specific traumatic event. Peripheral sensory and motor dysfunction was present in each patient. Radiographs of the elbow revealed dislocation, fracture fragmentation, and heterotopic ossification. Our management of the neuropathic elbows centered on maintenance of a functional arc of motion through physical therapy aimed at regaining muscle strength and the use of orthoses for support. Operative treatment was performed for an associated ulnar or radial nerve compression syndrome in three patients, and an open reduction and internal fixation of an unstable proximal ulnar nonunion associated with loose implants was performed in one. RESULTS: The patients were followed for an average of nineteen months, with a range of twelve to thirty-six months. All patients had a pain-free elbow with a functional range of motion at the most recent follow-up examination, and none wished to have further treatment. The operatively treated ulnar nonunion united successfully. All three patients treated surgically for an associated nerve compression syndrome had recovery of nerve function. CONCLUSION: In the face of instability and gross distortion of the joint, the patients in this series demonstrated remarkably good function.- - - - - - - - - - ranking = 1keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
2/29. Avascular necrosis not Charcot's.BACKGROUND: A case of avascular necrosis (AN) of the navicular bone, in a 24-year-old woman with Type 1 diabetes with peripheral neuropathy, in the absence of any history of direct trauma is presented. The clinical and radiological features at presentation suggested an evolving Charcot arthropathy (CA), but subsequent serial x-rays clearly confirmed AN. CONCLUSIONS: Swelling and foot deformity in association with long-standing diabetic peripheral neuropathy is suggestive of CA, although AN, a less common condition, may show the same clinical features. It is therefore important to undertake further confirmatory radiological investigations if there is any doubt about the diagnosis.- - - - - - - - - - ranking = 0.12816398072876keywords = diabetes (Clic here for more details about this article) |
3/29. Charcot neuroarthropathy of the knee in Type 1 diabetes: treatment with total knee arthroplasty.BACKGROUND: Charcot neuroarthropathy is well recognized in diabetes, although it typically affects the joints of the forefoot and ankle. Neuroarthropathy affecting the knee in diabetes is extremely rare. The surgical options for treatment of Charcot neuroarthropathy remain poorly defined, particularly the use of arthroplasty with knee involvement. methods: We describe a case of neuroarthropathy of the knee in a patient with Type 1 diabetes. We also describe the successful management of the disorder with total knee arthroplasty-only the third such description. RESULTS: The case illustrates some of the typical radiological features of this uncommon condition, which may aid early diagnosis and limit morbidity.- - - - - - - - - - ranking = 0.89714786510134keywords = diabetes (Clic here for more details about this article) |
4/29. Charcot's joint: an overlooked diagnosis.Charcot's joint, also known as neuropathic osteoarthropathy, is a common complication of diabetes that often is unrecognized and misdiagnosed. It may be present in up to 35% of patients with diabetic neuropathy. This disorder causes progressive destruction of weight bearing joints leading to dislocations, fractures, and deformities. We report a case of Charcot's joint in a 55-year-old man with type two diabetes. He presented with unilateral foot and ankle swelling, foot pain, warmth, and erythema. A magnetic resonance image of his foot revealed changes consistent with a Charcot's joint. Treatment consisted of joint immobilization in a total contact cast and then an ankle foot orthosis with custom footware. Charcot's joint should be considered in patients with a unilateral, warm, erythematous, swollen foot without other systemic symptoms. Early recognition of a Charcot's joint is important in ultimate outcome. immobilization of the joint, patient education, and proper footcare and footware are essential in preventing further complications including ulceration and amputation.- - - - - - - - - - ranking = 0.25632796145753keywords = diabetes (Clic here for more details about this article) |
5/29. Charcot joint-like changes following ankle fracture in a patient with no underlying disease: report of a rare case.Charcot joint is a disease that often occurs in patients with diabetes mellitus, tabes dorsalis, syringomyelia, chronic alcoholism, leprosy, trauma, or infection after fractures and dislocations. The treatment for Charcot joint has various complications, such as skin lesions, infections, and delayed union. We present our experience with a male patient who developed Charcot joint-like changes without diabetes mellitus or any other disease after an ankle fracture due to minor trauma.- - - - - - - - - - ranking = 2keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
6/29. Bone mineral density during total contact cast immobilization for a patient with neuropathic (Charcot) arthropathy.BACKGROUND AND PURPOSE: diabetes mellitus (DM)-related neuropathic arthropathy of the foot is a destructive bone and joint process. The effect of cast immobilization and non-weight bearing on bone loss has not been well studied. The purpose of this case report is to describe the changes in bone mineral density (BMD) of the calcaneus in the feet of a patient with acute neuropathic arthropathy during total contact cast immobilization. CASE DESCRIPTION: The patient was a 34-year-old woman with type 1 DM, renal failure requiring dialysis, and a 7-week duration of neuropathic arthropathy of the midfoot. Intervention included total contact casting and minimal to no weight bearing for 10 weeks, with transition to therapeutic footwear. Ultrasound-derived estimates of BMD were taken of both involved and uninvolved calcanei. OUTCOME: Bone mineral density decreased for the involved foot (from 0.25 g/cm(2) to 0.20 g/cm(2)) and increased for the uninvolved foot (from 0.27 g/cm(2) to 0.31 g/cm(2)) during casting. DISCUSSION: The low initial BMD and further loss during casting suggest the need for transitional bracing and a well-monitored return to full activity to minimize the risk of recurrence and progression of foot deformity.- - - - - - - - - - ranking = 0.1589454838813keywords = mellitus (Clic here for more details about this article) |
7/29. The utilization of autologous growth factors for the facilitation of fusion in complex neuropathic fractures in the diabetic population.A review of current knowledge of autologous growth factors as used in foot and ankle surgery is presented. This knowledge is clinically correlated with 50 Charcot's foot reconstruction patients who had diabetes and who were randomized to a platelet-rich plasma (PRP) concentration system (Symphony, DePuy, Warsaw, indiana) or a hollow-fiber hemoconcentration system (Interpore Cross AGF, Interpore Cross, Irvine, california) trial. Although the literature supports the notion that Symphony produces a higher yield of intact platelets more consistently, clinically, a statistically significantly higher number of patients treated with Interpore Cross AGF went on to solid fusion. The findings may indicate that one type of PRP may be indicated for a particular clinical circumstance based on the patient's medical history and resultant local wound environment.- - - - - - - - - - ranking = 0.12816398072876keywords = diabetes (Clic here for more details about this article) |
8/29. Charcot neuroarthropathy: an unusual case and a review of the literature.Charcot neuroarthropathy is a devastating consequence of diabetes, requiring early identification and immediate management. A differentiation should be made from osteomyelitis and other pathologies. The authors describe a case of Charcot foot with radiological findings of complete fragmentation of the calcaneum. Further investigation with magnetic resonance and white cell-labeled imaging revealed osteomyelitis. Below-knee amputation was the only therapeutic option in this hindfoot collapse complicated with osteomyelitis.- - - - - - - - - - ranking = 0.12816398072876keywords = diabetes (Clic here for more details about this article) |
9/29. Charcot foot osteoarthropathy in diabetes mellitus.Charcot joint, a destructive bone and joint disorder of the foot, is becoming more common in long-term diabetic patients. The combination of diabetic neuropathy and painless trauma causes dislocation and collapse of the tarsal joints. The resulting soft tissue and osseous pathology easily mimics an infective episode. This report presents a review of the clinical identification, diagnosis, and treatment of this unusual diabetic complication, plus a review of three cases. Also, the pathogenesis of Charcot joint is explained in describing why surgery can be a viable treatment alternative in these patients, after careful evaluation. It is also necessary that physicians inspect the feet of their diabetic patients to rule out quiescent beginnings of Charcot joints. Referral to a podiatrist is recommended for long-term management of the Charcot foot.- - - - - - - - - - ranking = 4keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
10/29. Pseudoaneurysm of the dorsalis pedis artery after Lisfranc amputation.Pseudoaneurysm formation is usually associated with laceration, fracture, or iatrogenic arterial injury. However, it may also develop as a result of blunt trauma. We report the case of a pseudoaneurysm of the dorsalis pedis artery after a Lisfranc amputation in an individual with diabetes mellitus, Charcot joint changes in the left forefoot, and atherosclerosis of the distal vessels.- - - - - - - - - - ranking = 1keywords = diabetes mellitus, mellitus, diabetes (Clic here for more details about this article) |
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