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Osteopenia, neurological dysfunction, and the development of Charcot neuroarthropathy
M J Young1, A Marshall, J E Adams
1University Department of Medicine, Manchester Royal Infirmary, United Kingdom.
Objective:
To determine factors that might be associated with the development of Charcot neuroarthropathy.
Research Design And Methods:
This cross-sectional prevalence study examined neurological function and bone density in matched groups of neuropathic diabetic patients with and without radiological evidence of Charcot neuroarthropathy.
Results:
Patients with Charcot neuroarthropathy had a global impairment of neurological function that was significantly greater than that of otherwise matched non-Charcot neuropathic patients. All 17 Charcot patients had evidence of autonomic neuropathy compared with 10 of the control subjects (P = 0.03). The Charcot patients had evidence of reduced bone density in the lower limbs compared with the neuropathic control subjects (P = 0.009), but relatively preserved bone density in the spine (P = 0.4 vs. control subjects).
Conclusions:
We conclude that minor trauma in diabetic patients with peripheral neuropathy might result in a fracture in those with a reduced bone density and thus trigger the development of Charcot neuroarthropathy.