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What is Charcot
Neuroarthropathy?
Charcot neuroarthropathy
is a term to describe
degenerative joint
destruction as a result
of the combination of
trauma and impaired
sensation. The
mechanism is one of the
unrecognized mechanical
microtrauma, such as
everyday waling, in a
joint that has been
rendered insensitive to
proprioception and
pain. Vascular
insufficiency is also
believed to aid bone
resorption and
ligamentous
instability. The
disorder can progress to
joint destruction,
fractures, and collapse
of the ankle and foot.
Symptoms
Charcot Neuroarthropathy
initially causes warmth,
swelling, and redness of
the foot. It may lead
to changes in the shape
of the ankle and foot,
and ulcers over new bony
prominences. Pain is
rarely a presenting
symptom.
Causes
Diabetes is by far the
most common cause of
Charcot joints. The
ratio of men to women is
about equal, and the
average duration of
diabetes prior to the
occurrence of the
Charcot joint is over 10
years, with a range of
zero to 45 years.
Charcot joints occur
bilaterally in 30% of
cases. There is no
relationship between the
severity of the
neuropathy and the
severity of the
diabetes. Other causes
of Charcot
neuroarthropathy include
alcoholism, strokes,
syringomyelia,
congenital insensitivity
to pain, hereditary
Charcot-Marie-Tooth
Disease, Fredrich's
Ataxia, spinal cord
injuries, and peripheral
nerve injuries.
Treatment and Prevention
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Patient Education
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Weight control
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Avoidance of smoking
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Daily foot inspection
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Good foot hygiene, dry
carefully
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Metabolic control of
glucose level
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Proper shoe wear
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Early accommodative
orthotics, bracing
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Surgery to remove bony
prominences
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Surgical Arthrodesis
(Fusion)
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