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Can anyone help with a query I have re. the pathomechanics of the Charcot Foot.
A medic recently informed me that they had found micro fractures in severe neuropathic feet with diabetes. This was thought to be a predicter of Charcot onsett but on further investigation this was not the case.

My question is what are the hormonal mediators of bone modelling and are they effected by long term diabetes? Also, can the Mechanostatic mechanism of bone modelling also be effected e.g. stress response?
The reasoning for this question is that if these mechanisms are absent in the Charcot foot and not in the non-Charcot, could we have a potential predictor?

I have tried searching for this info but due to a lack of knowledge of Biochemistry, I am floudering a bit.

Any help or comments greatfully received.

Cheers

Phil Wells

This may help:
Exp Clin Endocrinol Diabetes. 2006 Mar;114(3):118-23
The diabetic charcot foot: MRI discloses bone stress injury as trigger mechanism of neuroarthropathy.
Chantelau E, Richter A, Schmidt-Grigoriadis P, Scherbaum WA.

"It is generally accepted that traumatic bone injury contributes to the clinical picture of neuroarthropathy of the foot in diabetes, i.e., of the diabetic Charcot foot. While radiology is capable of visualizing only advanced bone injuries, like complete fractures, magnetic resonance imaging (MRI) discloses bone injuries that precede complete fractures (stress bone injuries). In diabetic polyneuropathy, stress bone injuries are silent in terms of pain, due to the lack of pain sensation. At the foot, their clinical appearance is characterized by inflammatory swelling with little or no pain. The present paper reviews the contribution of MRI to the detection of bone injuries in what is called stage 0 Charcot foot, with emphasis on the bearings for the treatment strategy."

__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
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Craig

Thanks for the link. I don't have access to this publication but will get a full copy ASAP.

Any ideas on where to look for the biochemistry bit or is there info info for me to chase in the reserach paper when I get it?

Cheers

Phil

What I try to do is get an X ray of my diabetic neuropathic patients.I did that,sure enough at least one gentleman did have an old unhealed fracture(he got the fracture while incarcerated)

hello
i want to know if there is a role of calcetonen in charcot foot managment
thank you
dr georges awad syria/ damascus

Pamidronate infusion timing in Charcot Rx