{"id":2212,"date":"2024-02-21T09:22:01","date_gmt":"2024-02-21T09:22:01","guid":{"rendered":"https:\/\/paleyinstitute.org\/?page_id=2212"},"modified":"2024-10-28T18:48:00","modified_gmt":"2024-10-28T18:48:00","slug":"charcot-neuroarthropathy","status":"publish","type":"page","link":"https:\/\/paleyinstitute.org\/charcot-neuroarthropathy\/","title":{"rendered":"Charcot Neuroarthropathy"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2212\" class=\"elementor elementor-2212\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c37f8fb elementor-section-full_width elementor-section-height-min-height elementor-section-height-default elementor-section-items-middle wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"c37f8fb\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a9daa2a\" data-id=\"a9daa2a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-61bdc21 elementor-widget elementor-widget-heading\" data-id=\"61bdc21\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Charcot Neuroarthropathy<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-42837a0 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"42837a0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e4026fd\" data-id=\"e4026fd\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7b2c612 elementor-widget elementor-widget-text-editor\" data-id=\"7b2c612\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Charcot Neuroarthropathy is a neauropathic joint disease that is a common complication of diabetes. Problems that occur as a result of this disease are fractures, dislocations, and rapid destruction of foot joints. The diagnosis of Charcot neuroarthropathy is made clinically after observing a lack of normal foot sensation, presence of ulcerations, and presence of foot deformity due to joint dislocation. It is a chronic and progressive joint disease that leads to the destruction of joints and surrounding bony structures and may lead to amputation if left untreated. Charcot neuroarthropathy commonly occurs in the foot and ankle, but can also occur in the shoulder, the elbow, and the knee. While most patients with Charcot neuroarthropathy have type 2 diabetes, other risk factors have been identified, including:<\/p><ul><li>Alcoholism<\/li><li>Leprosy<\/li><li>Myelomeningocele<\/li><li>Syphilis (tabes dorsalis)<\/li><li>Syringomyelia<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-af71b4e elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"af71b4e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ddc50cc\" data-id=\"ddc50cc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-957df62 elementor-widget elementor-widget-text-editor\" data-id=\"957df62\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p class=\"text-p-gap\">The cause of Charcot neuroarthropathy is not well understood but there are two major theories: a neurovascular theory and a neurotraumatic theory. The neurovascular theory states that increased blood flow (hyperemia) to the limb causes bone resorption and weakening. Increased blood flow is thought to be caused by dilation of the blood vessels due to denervation of the nerves.<\/p><p class=\"text-p-gap\">The neurotraumatic theory states that patients experience an overuse injury due to a lack of protective sensation. The nervous system protects the body by sending adverse signals when part of the body is in harm, forcing the body to adjust. Without these sensations, the body\u2019s normal protective mechanisms (e.g. body-weight shifting, limiting activity, and muscle guarding) are absent, causing injury over time. The mechanism for Charcot neuroarthropathy is probably a combination of both theories.<\/p><p class=\"text-p-gap\">Various stages of Charcot neuroarthropathy have been identified:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-56e33ea elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"56e33ea\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-a3d614c\" data-id=\"a3d614c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-87c75f4 elementor-widget elementor-widget-icon-box\" data-id=\"87c75f4\" data-element_type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tStage 0\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<p class=\"elementor-icon-box-description\">\n\t\t\t\t\t\t<ul style=\"color:#font-size: 18px;\">\n<li style=\"list-style:disc;line-height: 1.6;\">Characterized by swelling, warmth, joint instability, and normal anatomy<\/li>\n\n<\/ul>\t\t\t\t\t<\/p>\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-f7eb15d\" data-id=\"f7eb15d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0fe2db5 elementor-widget elementor-widget-icon-box\" data-id=\"0fe2db5\" data-element_type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tStage 1\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<p class=\"elementor-icon-box-description\">\n\t\t\t\t\t\t<ul style=\"color:#000;font-size: 18px;\">\n<li style=\"list-style:disc;line-height: 1.6;\">Characterized by fragmentation of bones and cartilage, joint dislocation, soft-tissue edema, hyperemia, bone resorption, and intra-articular fractures<\/li>\n\n<\/ul>\t\t\t\t\t<\/p>\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-c797dbd\" data-id=\"c797dbd\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0f4accc elementor-widget elementor-widget-icon-box\" data-id=\"0f4accc\" data-element_type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tStage 2\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<p class=\"elementor-icon-box-description\">\n\t\t\t\t\t\t<ul style=\"color:#000;font-size: 18px;\">\n<li style=\"list-style:disc;line-height: 1.6;\">Characterized by decreased soft-tissue edema, organization of bone fragments, and fracture heaing<\/li>\n\n<\/ul>\t\t\t\t\t<\/p>\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-top-column elementor-element elementor-element-108530a\" data-id=\"108530a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6adfd25 elementor-widget elementor-widget-icon-box\" data-id=\"6adfd25\" data-element_type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<h3 class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<span  >\n\t\t\t\t\t\t\tStage 3\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/h3>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<p class=\"elementor-icon-box-description\">\n\t\t\t\t\t\t<ul style=\"color:#000;font-size: 18px;\">\n<li style=\"list-style:disc;line-height: 1.6;\">Characterized by new bone formation and bone remodeling<\/li>\n\n<\/ul>\t\t\t\t\t<\/p>\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5ab39ba elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no\" data-id=\"5ab39ba\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fceef69\" data-id=\"fceef69\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6734138 elementor-widget elementor-widget-text-editor\" data-id=\"6734138\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p class=\"text-p-gap\">Charcot deformities of the foot and ankle can vary considerably in terms of severity and location. Generally, the Charcot foot is larger in size than a normal foot. The clinical presentation will vary depending on the stage of the disease. Stage 1 presents like an infection: a swollen, warm foot. Chronic (stages 2 and 3) Charcot foot presents with severe foot and ankle deformities.<\/p><p class=\"text-p-gap\">Ulceration and infection is commonly associated with Charcot neuroarthropathy. Chronic ulcerations can lead to osteomyelitis (bone infection). In these cases, the infected bone should be resected before or during reconstruction.<\/p><p class=\"text-p-gap\">At the Paley Institute, we have treated the full spectrum of the sequelae of Charcot neuroarthropathy. We can stabilize the foot with an external fixator, reconstruct the bony deformities, and address the ulcerations with wound healing. During the initial consultation, we will assess the foot and ankle, including ulcerations and osteomyelitis, and use x-rays to determine the location and severity of the boney deformities. Treatment depends on the stage of the disease, the anatomic location of the deformity, the presence or absence of osteomyelitis (bone infection), and the stability of the foot.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9eeef61 elementor-widget__width-initial elementor-align-center elementor-widget elementor-widget-button\" data-id=\"9eeef61\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-md\" href=\"https:\/\/paleyinstitute.org\/charcot-neuroarthropathy-treatment-strategies\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">TREATMENT STRATEGIES<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Charcot Neuroarthropathy Charcot Neuroarthropathy is a neauropathic joint disease that is a common complication of diabetes. Problems that occur as a result of this disease are fractures, dislocations, and rapid destruction of foot joints. The diagnosis of Charcot neuroarthropathy is made clinically after observing a lack of normal foot sensation, presence of ulcerations, and presence of foot deformity due to joint dislocation. It is a chronic and progressive joint disease that leads to the destruction of joints and surrounding bony structures and may lead to amputation if left untreated. Charcot neuroarthropathy commonly occurs in the foot and ankle, but can also occur in the shoulder, the elbow, and the knee. While most patients with Charcot neuroarthropathy have type 2 diabetes, other risk factors have been identified, including: Alcoholism Leprosy Myelomeningocele Syphilis (tabes dorsalis) Syringomyelia The cause of Charcot neuroarthropathy is not well understood but there are two major theories: a neurovascular theory and a neurotraumatic theory. The neurovascular theory states that increased blood flow (hyperemia) to the limb causes bone resorption and weakening. Increased blood flow is thought to be caused by dilation of the blood vessels due to denervation of the nerves. The neurotraumatic theory states that patients experience an overuse injury due to a lack of protective sensation. The nervous system protects the body by sending adverse signals when part of the body is in harm, forcing the body to adjust. Without these sensations, the body\u2019s normal protective mechanisms (e.g. body-weight shifting, limiting activity, and muscle guarding) are absent, causing injury over time. The mechanism for Charcot neuroarthropathy is probably a combination of both theories. Various stages of Charcot neuroarthropathy have been identified: Stage 0 Characterized by swelling, warmth, joint instability, and normal anatomy Stage 1 Characterized by fragmentation of bones and cartilage, joint dislocation, soft-tissue edema, hyperemia, bone resorption, and intra-articular fractures Stage 2 Characterized by decreased soft-tissue edema, organization of bone fragments, and fracture heaing Stage 3 Characterized by new bone formation and bone remodeling Charcot deformities of the foot and ankle can vary considerably in terms of severity and location. Generally, the Charcot foot is larger in size than a normal foot. The clinical presentation will vary depending on the stage of the disease. Stage 1 presents like an infection: a swollen, warm foot. Chronic (stages 2 and 3) Charcot foot presents with severe foot and ankle deformities. Ulceration and infection is commonly associated with Charcot neuroarthropathy. Chronic ulcerations can lead to osteomyelitis (bone infection). In these cases, the infected bone should be resected before or during reconstruction. At the Paley Institute, we have treated the full spectrum of the sequelae of Charcot neuroarthropathy. We can stabilize the foot with an external fixator, reconstruct the bony deformities, and address the ulcerations with wound healing. During the initial consultation, we will assess the foot and ankle, including ulcerations and osteomyelitis, and use x-rays to determine the location and severity of the boney deformities. Treatment depends on the stage of the disease, the anatomic location of the deformity, the presence or absence of osteomyelitis (bone infection), and the stability of the foot. TREATMENT STRATEGIES<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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