From the Guidelines
Treatment of a charqu joint, also known as a Charcot joint or neuropathic arthropathy, should focus on immobilization and offloading pressure, typically using a non-removable knee-high device, such as a total contact cast (TCC) or a prefabricated walker made non-removable, for 8-12 weeks, as recommended by the guidelines on the diagnosis and treatment of active Charcot neuro-osteoarthropathy in persons with diabetes mellitus (IWGDF 2023) 1, 2, 3, 4, 5, 6, 7.
Key Considerations
- Immobilization and offloading are crucial to prevent further joint destruction and promote healing.
- Non-weight bearing is recommended initially, with gradual return to protected weight bearing.
- Pain management may include NSAIDs like ibuprofen (400-800mg three times daily) or acetaminophen (500-1000mg every 6 hours).
- Surgical intervention is reserved for cases with severe instability or deformity that don't respond to conservative measures.
Diagnosis and Monitoring
- Diagnosis is based on clinical signs of inflammation, such as increased temperature, edema, and redness, as well as signs of bone or joint injury/abnormalities on imaging studies like plain X-ray or MRI.
- Regular monitoring with X-rays every 2-4 weeks during active disease is essential to track progression and adjust treatment accordingly.
Treatment Options
- Total contact cast (TCC) is the preferred method of offloading, but a prefabricated knee-high walker made non-removable can be considered as a second choice.
- Removable knee-high devices can be considered as a third treatment choice, but are less effective in immobilizing and offloading the foot.
- Below-the-ankle devices are not recommended due to inadequate immobilization and offloading capacity.
Important Considerations
- Treatment should be individualized based on patient factors, such as mobility, motivation, and socioeconomic status.
- Healthcare professionals should have access to high-quality training and resources to provide optimal care for patients with charqu joint.
- Patient education and shared decision-making are essential to ensure adherence to treatment and optimal outcomes.
From the Research
Charqu Joint
There is no direct information available on "charqu joint" in the provided studies.
- The studies focus on rheumatoid arthritis, its treatment, and management, with discussions on disease-modifying antirheumatic drugs (DMARDs), biologic agents, and methotrexate 8, 9, 10, 11, 12.
- They explore the use of methotrexate in combination with other DMARDs or biologic agents for treating rheumatoid arthritis, highlighting the importance of methotrexate as a first-line treatment 8, 10.
- The studies also touch upon the potential side effects of these treatments, the need for monitoring, and considerations for dosage adjustments 9, 11.
- However, none of the studies mention "charqu joint" specifically, suggesting that there may not be relevant research available on this topic within the provided evidence.