Characteristics of Patients with Charcot's Arthropathy and its Complications in the Saudi Diabetic Population: A
Insights
Charcot
Area of Science:
- Diabetic foot complications
- Rheumatology
- Podiatry
Background:
- Charcot's arthropathy (CA) is a rare, destructive diabetic complication.
- Diagnosis of CA presents challenges for foot specialists and surgeons.
Purpose of the Study:
- To assess the clinical presentation and characteristics of Charcot's arthropathy.
- To determine the frequencies of various Charcot's arthropathy types.
Main Methods:
- Cross-sectional study from 2007-2016.
- Included 149 adult patients with diabetes diagnosed with CA.
- Classified CA cases using the Brodsky anatomical classification into five types.
Main Results:
- Mean age 56.7 years; mean diabetes duration 21.2 years.
- High rates of neuropathy, retinopathy, and poorly controlled diabetes observed.
- Type 4 (multiple regions) was most frequent (56.4%), followed by Type 1 (midfoot, 34.5%).
- 47.7% had bilateral CA; 67.7% of affected limbs had foot ulceration.
- Hammertoe (100%), hallux valgus (59.5%), and flatfoot (21.8%) were common deformities.
Conclusions:
- High prevalence of bilateral, Type 4 CA noted, potentially linked to cultural footwear habits.
- Increased awareness and preventive measures for CA are crucial.
- Proper footwear is essential for avoiding diabetic foot complications like CA.
Background:
Charcot's arthropathy (CA) is a destructive rare complication of diabetes, and its diagnosis remains challenging for foot specialists and surgeons. We aimed to assess the clinical presentation and characteristics of CA and the frequencies of its various types.
Methods:
This cross-sectional study was conducted from January 1, 2007, to December 31, 2016, and included 149 adults with diabetes diagnosed as having CA. Cases of CA were classified based on the Brodsky anatomical classification into five types according to location and involved joints.
Results:
The mean ± SD age of the studied cohort was 56.7 ± 11 years, with a mean ± SD diabetes duration of 21.2 ± 7.0 years. The CA cohort had poorly controlled diabetes and a high rate of neuropathy and retinopathy. The most frequent type of CA was type 4, with multiple regions involved at a rate of 56.4%, followed by type 1, with midfoot involvement at 34.5%. A total of 47.7% of the patients had bilateral CA. Complications affected 220 limbs, of which 67.7% had foot ulceration. With respect to foot deformity, hammertoe affected all of the patients; hallux valgus, 59.5%; and flatfoot, 21.8%.
Conclusions:
There is a high rate of bilateral CA, mainly type 4, which could be attributed to cultural habits in Saudi Arabia, including footwear. This finding warrants increasing awareness of the importance of maintaining proper footwear to avoid such complications. Implementation of preventive measures for CA is urgently needed.
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