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Published on: July 7, 2023
Follow-Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment
Johan Schoug1,2, Per Katzman1,2, Erik Uddman1,2
1Department of Endocrinology, Skåne University Hospital, Lund, Sweden.
Aims/Hypothesis:
Charcot foot (CF), a potentially debilitating complication of neuropathy, requires offloading to avoid foot deformities. Follow-up MRI examinations are often used to determine the optimal duration of total contact cast (TCC) offloading treatment. This study investigated the use of follow-up MRI during CF treatment and its relationship to offloading duration and risk of future surgery.
Methods:
People with diabetes mellitus and MRI-confirmed CF treated at Skåne University Hospital (Lund and Malmö, Sweden) between 2006 and 2022 were studied retrospectively. Individuals monitored with follow-up MRI examinations were compared with those who only underwent diagnostic MRI. A regression model was applied to evaluate factors predicting TCC and total CF treatment duration.
Results:
One-hundred and twenty-two individuals (45 [37%] DM1; 47 [39%] women; median age 60 [IQR 53-68] years) with a total of 143 CF events were included. 76 (53%) of these CF events were monitored using a total of 141 follow-up MRI examinations. Individuals monitored with MRI had significantly longer TCC and total CF treatment durations (p < 0.001). Individual characteristics (with the exception of sex), rate of stage 1 CF, and risk of future surgery did not differ between the two groups and only use of follow-up MRI (p < 0.001) remained a significant predictor of both longer TCC and total CF treatment durations in a regression model.
Conclusions/Interpretation:
In this retrospective cohort study, use of follow-up MRI was associated with longer TCC and total treatment times despite similar characteristics and outcomes. Prospective studies are needed to further elucidate the optimal use of MRI in monitoring CF.
