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Diabetic neuroarthropathy.

S A Qidwai1, M A Khan, S R Hussain

  • 1King Khalid Hospital, Najran, Kingdom of Saudi Arabia.

Saudi Medical Journal
|April 12, 2001
PubMed
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Diabetic neuroarthropathy affects 4% of patients with diabetes and peripheral neuropathy. Early detection through imaging is crucial to prevent severe foot complications in high-risk individuals.

Area of Science:

  • Podiatry
  • Diabetology
  • Radiology

Background:

  • Diabetic neuroarthropathy is a severe complication of diabetes mellitus.
  • It often presents in patients with long-standing, poorly controlled diabetes and peripheral neuropathy.
  • Early identification and management are critical to prevent debilitating foot deformities and amputations.

Purpose of the Study:

  • To determine the incidence of diabetic neuroarthropathy and associated morbidity in a diabetic patient cohort.
  • To evaluate clinical and radiographic findings indicative of diabetic neuroarthropathy.
  • To assess treatment outcomes for diabetic neuroarthropathy.

Main Methods:

  • Retrospective analysis of 296 diabetic patients' medical records from June 1998 to July 1999.

Related Experiment Videos

  • Clinical assessment for neuropathy (absent ankle jerk, sensory loss) and radiographic evaluation for arthropathic changes (fractures, dislocations, bone lesions).
  • Treatment modalities included conservative (total contact casting) and surgical (excision, amputation) approaches, with an average follow-up of 13 months.
  • Main Results:

    • Diabetic neuropathy was identified in 12.5% of patients; 4% (11 patients) had diabetic neuroarthropathy.
    • The tarsometatarsal joints were most commonly affected (76%), followed by metatarsophalangeal (59%), subtalar (47%), and interphalangeal joints (41%).
    • Total contact casting showed satisfactory progress, while two patients required foot amputations.

    Conclusions:

    • Diabetic neuroarthropathy is an under-recognized complication requiring increased attention, particularly in Saudi Arabia.
    • Routine radiography or CT scans are recommended for high-risk diabetic feet to facilitate early detection.
    • Timely diagnosis can avert severe outcomes and prevent devastating complications.