[Charcot neuroarthropathy in Argentina: cohort study in two tertiary-level hospitals]

Charcot neuroarthropathy (CN) is a complication of diabetes that can lead to deformities and increase the risk of amputation. This study describes the characteristics and evolution of patients with CN in two hospitals in Argentina.

A prospective cohort study was conducted on 83 patients with CN who were consecutively treated between August and December 2023 at the National Hospital Alejandro Posadas (HNAP) and the Italian Hospital of Buenos Aires (HIBA).

Of the patients, 69.8% (58) were male, with a mean age of 51.8 (12.5) years, and 78.3% (65) had type 2 diabetes. Active-phase CN was present in 50 (60.2%) of cases. The temperature difference between both feet was 2.5°C in the active phase vs. 0.3°C in the inactive phase (p<0.01). Ulcers were observed in 47% of patients, more frequently at HNAP (57.1%) than at HIBA (25.9%, p<0.01). Compared to HNAP, HIBA had a lower proportion of male patients, a higher prevalence of type 1 diabetes, and more patients undergoing dialysis. Patients were followed for a median of 223 days (168-248). Among the 39 patients with ulcers, 19 (48.7%) healed, 19 (48.7%) had persistent ulcers, and one (2.6%) required major amputation. The incidence density of new ulcers was 2.7% per month in patients without prior lesions.

CN is an underdiagnosed disease with severe consequences if not detected and treated early. This study provides valuable information on its presentation and characteristics, highlighting the need for prevention strategies and early diagnosis.