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Charcot foot and Bone re-modelling

Discussion in 'Diabetic Foot & Wound Management' started by Phil Wells, Sep 20, 2006.

  1. Phil Wells

    Phil Wells Active Member


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    Can anyone help with a query I have re. the pathomechanics of the Charcot Foot.
    A medic recently informed me that they had found micro fractures in severe neuropathic feet with diabetes. This was thought to be a predicter of Charcot onsett but on further investigation this was not the case.

    My question is what are the hormonal mediators of bone modelling and are they effected by long term diabetes? Also, can the Mechanostatic mechanism of bone modelling also be effected e.g. stress response?
    The reasoning for this question is that if these mechanisms are absent in the Charcot foot and not in the non-Charcot, could we have a potential predictor?

    I have tried searching for this info but due to a lack of knowledge of Biochemistry, I am floudering a bit.

    Any help or comments greatfully received.

    Cheers

    Phil Wells
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    7
    This may help:
    Exp Clin Endocrinol Diabetes. 2006 Mar;114(3):118-23
    The diabetic charcot foot: MRI discloses bone stress injury as trigger mechanism of neuroarthropathy.
    Chantelau E, Richter A, Schmidt-Grigoriadis P, Scherbaum WA.

    "It is generally accepted that traumatic bone injury contributes to the clinical picture of neuroarthropathy of the foot in diabetes, i.e., of the diabetic Charcot foot. While radiology is capable of visualizing only advanced bone injuries, like complete fractures, magnetic resonance imaging (MRI) discloses bone injuries that precede complete fractures (stress bone injuries). In diabetic polyneuropathy, stress bone injuries are silent in terms of pain, due to the lack of pain sensation. At the foot, their clinical appearance is characterized by inflammatory swelling with little or no pain. The present paper reviews the contribution of MRI to the detection of bone injuries in what is called stage 0 Charcot foot, with emphasis on the bearings for the treatment strategy."
     
  3. Phil Wells

    Phil Wells Active Member

    Craig

    Thanks for the link. I don't have access to this publication but will get a full copy ASAP.

    Any ideas on where to look for the biochemistry bit or is there info info for me to chase in the reserach paper when I get it?

    Cheers

    Phil
     
  4. John Spina

    John Spina Active Member

    What I try to do is get an X ray of my diabetic neuropathic patients.I did that,sure enough at least one gentleman did have an old unhealed fracture(he got the fracture while incarcerated)
     
  5. drgorgs

    drgorgs Member

    hello
    i want to know if there is a role of calcetonen in charcot foot managment
    thank you
    dr georges awad syria/ damascus
     
  6. admin

    admin Administrator Staff Member

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