1/15. Destructive hip disease complicating traumatic paraplegia.Recent progress in the management of spinal cord injury has provided longer survivals, and as a result the incidence of secondary bone and joint disorders has increased. Joint lesions due to syringomyelia complicating a cervical spinal cord injury are the most common of these disorders. We report a case of destructive hip disease 7 years after an injury responsible for complete paraplegia with sensory loss. The joint lesions were painless, and there was no local evidence of inflammation. hip radiographs disclosed atrophic osteoarthropathy with complete destruction of the femoral neck and head. This unusual case raises questions about the pathophysiology of neuropathic osteoarthropathy in paraplegics.- - - - - - - - - - ranking = 1keywords = osteoarthropathy (Clic here for more details about this article) |
2/15. An unusual case of bilaterally symmetrical neuropathic osteoarthropathy of the midfoot as a result of lyme disease-induced peripheral neuropathy: a case report.The first known report of a patient with lyme disease-induced peripheral neuropathy resulting in bilaterally symmetrical "Charcot" changes of the midfoot is reported. An extensive review of the literature failed to produce any known cases of neuropathic osteoarthropathy that would be linked directly or indirectly with lyme disease-induced peripheral neuropathy. The relationship between lyme disease, the secondary neurologic manifestations caused by the infection, and neuropathic osteoarthropathy are discussed.- - - - - - - - - - ranking = 3keywords = osteoarthropathy (Clic here for more details about this article) |
3/15. Neuropathic osteoarthropathy in the diabetic foot.OBJECTIVE: To discuss a case involving a 55-year-old diabetic woman with neuropathic osteoarthropathy initiated by a fall. CLINICAL FEATURES: The patient fell into a hole, injuring her left foot. Because of the anesthesia associated with her diabetic peripheral neuropathy, she did not notice the ensuing plantar puncture wound. The patient assumed that her swelling was a result of a sprain. Mild dislocation and osseous fragmentation was noted within the midfoot on radiographs. The neuropathic osteoarthropathy progressed until the patient was later casted. Plain films taken at the time of cast removal demonstrated resorption and consolidation of fragmentation, but the dislocation was unaltered. INTERVENTION AND OUTCOME: The patient was scheduled for surgery and wound debridement. However, before surgery, complications of a burn sustained on the contralateral foot required fifth ray amputation. Surgery of the left foot has been postponed until adequate postsurgical healing has occurred at the right foot amputation site. CONCLUSION: This article provides tools for the timely diagnosis and treatment of neuropathic osteoarthropathy. An increased understanding of this entity will help lead to a reduction in the incidence of delayed treatment resulting from misdiagnosis.- - - - - - - - - - ranking = 3.5keywords = osteoarthropathy (Clic here for more details about this article) |
4/15. 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 = 0.5keywords = osteoarthropathy (Clic here for more details about this article) |
5/15. Charcot osteoarthropathy in a case of klippel-trenaunay-weber syndrome.A case of a patient with klippel-trenaunay-weber syndrome (KTW) with Charcot osteoarthropathy is presented. A medline literature review was performed using the words Klippel-Trenaunay, orthopaedic, ankle, foot, and Charcot joint. Seven articles reported orthopaedic manifestations of KTW. They included limb hypertrophy and atrophy, limb-length discrepancies, digital anomalies, ulcerations, and spine and hip abnormalities, but no mention of Charcot osteoarthropathy. After many years of chronic nonhealing ulcers and repeated incision and drainage procedures the patient developed Charcot osteoarthropathy of the ankle without evidence of osteomyelitis or peripheral neuropathy but with severe deformity that required transtibial amputation.- - - - - - - - - - ranking = 3.5keywords = osteoarthropathy (Clic here for more details about this article) |
6/15. [Charcot foot treated by correction and arthrodesis of the hindfoot]THE PROBLEM: First patient: neuropathic osteoarthropathy with severely deformed foot, plantar ulceration and recurrent purulent infections. Second patient: diabetic osteoarthropathy with pathologic fracture. CLINICAL FINDINGS: First patient: 50-year-old man with hereditary sensory and motor neuropathy, plantar ulceration, equinus of the hindfoot, and extensive destruction of all bones of the foot. Recurrent infections necessitated repeated surgical interventions during the last 7 years. At the time of admission purulent infection of the foot. Healing after debridement including a resection of metatarsal bones and part of sequestrated bones of the foot. Patient was left with a severe equinus of the hindfoot. TREATMENT OPTIONS: Orthopedic shoes with or without below-knee orthesis. Lengthening of the achilles tendon and plantar alignment of the calcaneus. arthrodesis of the hindfoot. Below-knee amputation, if necessary as a primary procedure to combat infection. THE SOLUTION: arthrodesis of the hindfoot after realignment; an amputation of the foot was refused. SURGICAL TECHNIQUE: Two-stage procedure: treatment of infection followed by astragalectomy and tibiocalcaneal arthrodesis achieved with cancellous lag screws. Bridging of the area of resection with a segment of the fibula. RESULT: Bony fusion and full load bearing in an orthopedic shoe after 3 months. recurrence of ulcerations after 20 and 27 months due to wear of ill-fitting shoes. The accompanying purulent process forced the authors to resort to a below-knee amputation and fitting of a prosthesis. Second patient: of this patient only radiographs with a retrograde introduced intramedullary nail are shown.- - - - - - - - - - ranking = 1keywords = osteoarthropathy (Clic here for more details about this article) |
7/15. 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 = 2keywords = osteoarthropathy (Clic here for more details about this article) |
8/15. The diabetic foot with synovial cyst.Diabetic lower extremity infections, frequently polymicrobial, are at times fascinating though frustrating for the practitioner to treat. The classical triad of neuropathy, infection, and angiopathy is the hallmark of diabetic foot pathology. One of the main forms demonstrating the severe long-term neuropathic disease is called osteoarthropathy or Charcot joint. This is usually relatively painless, always progressive, and frequently destructive. It generally attacks the midtarsal joint and eventually changes the entire architecture of the foot, causing the so-called "rocker bottom" foot type. We present a case of a severely destructive Charcot foot that caused a large synovial cyst because of its vast underlying osseous pathology. The morbidity and mortality of these infections can be minimized by understanding the unique challenges these individuals offer the practitioner.- - - - - - - - - - ranking = 0.5keywords = osteoarthropathy (Clic here for more details about this article) |
9/15. Combined leukocyte and bone imaging used to evaluate diabetic osteoarthropathy and osteomyelitis.Six diabetic patients with roentgenographic finding of osteomyelitis, osteoarthropathy, or both, had combined leukocyte and bone imaging. Bone images demonstrated increased activity in all cases, including three without osteomyelitis. Leukocyte images, however, showed increased activity in only the three cases of osteomyelitis. There was minimal or no activity in the other three cases where osteoarthropathy was ultimately believed to be the basis of the roentgenographic and bone imaging changes.- - - - - - - - - - ranking = 3keywords = osteoarthropathy (Clic here for more details about this article) |
10/15. Diabetic neuro-osteoarthropathy. rehabilitation of a patient with both ankle joints involved and associated skin problems.Neuro-osteoarthropathy in diabetes mellitus is not rare. The case of a 53-year-old diabetic with involvement of both ankle joints and multiple associated skin problems complicating rehabilitation management is discussed. By applying a team approach, closely monitoring the patient's skin and joint problems, and treating them at an early stage by adaptive shoes and orthoses, we found that function could be sustained at an optimal level for a prolonged period. In addition to prevention of ulceration, modifying the weight bearing or temporarily non-weight bearing is the treatment of choice. amputation is to be considered only as a last resort.- - - - - - - - - - ranking = 2.5keywords = osteoarthropathy (Clic here for more details about this article) |
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