From the Guidelines
Charcot joint, also known as neuropathic arthropathy, requires immediate immobilization and offloading to prevent further joint destruction and potential amputation, especially in diabetic patients with intact skin, as recommended by the most recent guidelines 1.
Diagnosis and Treatment
The diagnosis of Charcot neuro-osteoarthropathy should consider clinical findings of increased temperature, edema, and/or redness of the foot compared to the contralateral foot in a person with diabetes mellitus and neuropathy 1.
- Infrared thermometry can be used to measure skin temperature, with a standardized approach for accurate comparison over time 1.
- Plain X-ray of the foot and ankle, including anteroposterior, medial oblique, and lateral projections, should be performed to confirm or rule out active Charcot neuro-osteoarthropathy 1.
- Magnetic Resonance Imaging (MRI) is recommended if plain X-rays appear normal, to diagnose or exclude the disease and its activity 1.
Management
- Initiate knee-high immobilization/offloading promptly, using a total contact cast or removable walking boot, to reduce weight-bearing on the affected limb 1.
- Non-weight bearing is recommended initially, with gradual return to protected weight bearing.
- Custom footwear and braces are essential for long-term management.
- Medications like bisphosphonates are not recommended for treatment of active Charcot neuro-osteoarthropathy 1.
- Surgery is reserved for severe cases with significant deformity or instability.
Importance of Early Recognition and Treatment
Early recognition and treatment of Charcot joint are vital to prevent permanent deformity and potential amputation, especially in diabetic patients where this condition commonly occurs 1.
- The true incidence and prevalence of Charcot neuro-osteoarthropathy in diabetes mellitus are unknown, but it is estimated that approximately 1.6 million people worldwide are living with this condition 1.
- Patient-reported health-related quality of life is negatively impacted by Charcot neuro-osteoarthropathy, and the condition can result in permanent deformity of the foot and/or ankle, predisposing to ulceration and infection 1.
From the Research
Charqu Joint
There is no information available on "charqu joint" in the provided studies.
- The studies focus on the treatment of rheumatoid arthritis, particularly the use of methotrexate as a disease-modifying antirheumatic drug (DMARD) 2, 3, 4, 5, 6.
- They discuss the efficacy and safety of methotrexate, its combinations with other DMARDs, and its role in the treatment of rheumatoid arthritis 2, 3, 4, 6.
- One study examines the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the disposition of methotrexate in patients with rheumatoid arthritis 5.
- However, none of the studies mention "charqu joint", suggesting that there is no relevant information available on this topic.