Editorial
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Diabetes. May 15, 2011; 2(5): 59-65
Published online May 15, 2011. doi: 10.4239/wjd.v2.i5.59
Charcot osteoarthropathy in diabetes: A brief review with an emphasis on clinical practice
Evanthia Gouveri, Nikolaos Papanas
Evanthia Gouveri, Nikolaos Papanas, Outpatient Clinic of the Diabetic Foot, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis 68100, Greece
Author contributions: Gouveri E performed the literature search and wrote the first draft; Papanas N conceived and finalized the manuscript.
Correspondence to: Nikolaos Papanas, MD, Outpatient Clinic of Obesity, Diabetes and Metabolism, the Second Department of Internal Medicine, Democritus University of Thrace, G. Kondyli 22, Alexandroupolis 68100, Greece. papanasnikos@yahoo.gr
Telephone: +30-2551-084972 Fax: +30-2551-074723
Received: October 11, 2010
Revised: March 26, 2011
Accepted: April 1, 2011
Published online: May 15, 2011
Abstract

Charcot osteoarthropathy (COA) is a potentially limbthreatening condition that mainly affects diabetic patients with neuropathy. In everyday practice, it presents as a red, hot, swollen foot, usually painless, and is frequently triggered by trivial injury. Its etiology is traditionally attributed to impairment of either the autonomic nervous system, leading to increased blood flow and bone resorption, or of the peripheral nervous system, whereby loss of pain and protective sensation render the foot susceptible to repeated injury. More recently, excessive local inflammation is thought to play a decisive role. Diagnosis is based on clinical manifestation and imaging studies (plain X-rays, bone scan, Magnetic Resonance Imaging). The mainstay of management is immediate off-loading, while surgery is usually reserved for chronic cases with irreversible deformities and/or joint instability. The aim of this review is to provide an overview of COA in terms of pathogenesis, classification and clinical presentation, diagnosis and treatment, with an emphasis on the high suspicion required by clinicians for timely recognition to avoid further complications.

Keywords: Charcot osteoarthropathy; Diabetes mellitus; Diabetic neuropathy; Diabetic foot