Arce GL, Cantor GJF, Mancera ÁJM, Tovar SMA

Language: Spanish
References: 8
Page:
PDF size: 204.33 Kb.

ABSTRACT

Introduction: Neuroarthropathy is a condition secondary to metabolic, infectious, or genetic diseases. Its usual localization is reported in the foot, but it can affect any joint, compromising its vascular status and modifying the bone condition generating fractures, contractures, and dislocations.
Objectives: To report the clinical and imaging findings of a patient with Charcot neuroarthropathy due to diabetes mellitus in a rare joint location.
Clinical Case: A 62-year-old woman from Colombian southwestern, with a history of diabetes mellitus, in addition to micro and macrovascular complications. She presented a clinical picture of joint pain in the right knee that evolved to an inability to walk. During her care, different imaging tests were performed, finding a fracture of the left femoral condyle and tibial plateau, these typical radiological characteristics plus the clinical changes of the joint, led to the diagnosis of Charcot’s knee. Pharmacological interventions were performed in pain in addition to joint immobilization, with adequate evolution in clinical follow-up.
Conclusions: Neuroarthropathy is a condition that should be evaluated in all patients with diabetes mellitus and other conditions, expanding the joint revision panorama to less frequent locations such as the knee; early and multidisciplinary intervention can favor positive clinical outcomes.

REFERENCES

1. Yang Q-H, Hsu P, Gao Y-S, Zhang C-Q. Charcot neuroarthropathy of the knee due to idiopathic sensory peripheral neuropathy. BMC Musculoskelet Disord. 2019; 20(1):501. DOI: 10.1186/s12891-019-2873-9

2. Gupta R. A short history of neuropathic arthropathy. Clin Orthop Relat Res. 1993 [acceso: 20/11/2021]; 296(1): 43-9 Disponible en: Disponible en: https://europepmc.org/article/med/8222448

3. Lu V, Zhang J, Thahir A, Zhou A, Krkovic M. Charcot knee - presentation, diagnosis, management - a scoping review. Clin Rheumatol. 2021; 40(11): 4445-6. DOI: 10.1007/s10067-021-05775-8

4. Barnes JA, Eid MA, Creager MA, Goodney PP. Epidemiology and Risk of Amputation in Patients With Diabetes Mellitus and Peripheral Artery Disease. Arterioscler Thromb Vasc Biol. 2020; 40(8):1808-17. DOI: 10.1161/ATVBAHA.120.314595

5. Konarzewska A, Korzon-Burakowska A, Rzepecka-Wejs L, Sudol-Szopinska I, Szurowska E, Studniarek M. Diabetic foot syndrome: Charcot arthropathy or osteomyelitis? Part I: Clinical picture and radiography. J Ultrason. 2018; 18 (72): 42-9. DOI: 10.15557/JoU.2018.0007

6. Robinson C, Major MJ, Kuffel C, Hines K, Cole P. Orthotic management of the neuropathic foot: an interdisciplinary care perspective. Prosthet Orthot Int. 2015; 39(1):73-81. DOI: 10.1177/0309364614545422

7. Rosenbaum AJ, DiPreta JA. Classifications in brief: Eichenholtz classification of Charcot arthropathy. Clin Orthop Relat Res. 2015; 473(3): 1168-71. DOI: 10.1007/s11999-014-4059-y

8. Bates D, Schultheis BC, Hanes MC, Jolly SM, Chakravarthy KV, Deer TR, et al. A Comprehensive Algorithm for Management of Neuropathic Pain. Pain Med. 2019; 20(1): S2-12. DOI: 10.1093/pm/pnz075