The Essentials of Charcot Neuroarthropathy

The Essentials of Charcot Neuroarthropathy

Biomechanics, Pathophysiology, and MRI Findings

1st Edition - May 11, 2022

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  • Author: Claude Pierre-Jerome
  • Paperback ISBN: 9780323993524
  • eBook ISBN: 9780323995788

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Description

The Essential Charcot Neuroarthropathy: Biomechanics, Pathophysiology, and MRI Findings provides a comprehensive analysis of Charcot neuroarthropathy (or Charcot Foot) in diabetic patients. All aspects are covered, including epidemiology, biomechanics, pathophysiology, socioeconomic impacts, radiological findings, and differential diagnosis, with an emphasis on MRI. Chapters address the challenges of pre-and-post surgical management of Charcot neuroarthropathy and the role of unconventional imaging modalities in diagnosis. The book presents an analysis of the normal biomechanics of the ankle and foot, the biomechanical derangements of the ankle-foot unit (including abnormal gait) caused by diabetes Type II, and more. Finally, there is also a reference of the pathophysiology of diabetes-induced peripheral neuropathy and its direct link with the development of Charcot neuroarthropathy foot. Diabetes-induced Charcot foot is frequently misunderstood, misinterpreted and misdiagnosed which can lead to confusion and detrimental management with reported high morbidity.

Key Features

  • Presents a clear differentiation of Charcot neuroarthropathy with other conditions such as osteoarthritis, gout, psoriasis, rheumatoid arthritis, the Madura foot, and others
  • Provides a state-of-art catalogue of all radiological features of Charcot neuroarthropathy with MRI
  • Describes the pre-and post-surgical procedures used for the management of Charcot neuroarthropathy and their socioeconomic impacts
  • Includes MRI color images of soft tissue damages for ease of understanding

Readership

Radiologists, Foot Surgeons, Podiatrists, Diabetologists, Radiologists in-training (residents, fellows). Researchers in Diabetes. Registered Nurses (specialists in foot care). Physical Therapists, Physical Assistants (specialists in foot care), Health Care Providers (General Practitioners, Family Physicians). Researchers in Musculoskeletal disorders, Researchers in Radiology, Nurse Practitioners, Medical Assistants. Chiropractors

Table of Contents

  • Cover image
  • Title page
  • Table of Contents
  • Copyright
  • List of contributors
  • Acknowledgments
  • Introduction
  • Chapter 1. Biomechanics of the ankle-foot unit: derangements and radiological signs
  • Abstract
  • 1.1 Basic biomechanics of the normal ankle-foot unit
  • 1.2 The ankle-foot unit: anatomy and structural organization
  • 1.3 The plantar arches of the foot: biomechanical functions
  • 1.4 The gait and gait cycle, normal biomechanics in the gait cycle
  • 1.5 The swing phase
  • 1.6 Muscle involvement in the gait phases, rocker action of the ankle-foot unit
  • 1.7 Gait abnormalities in the diabetic foot
  • 1.8 Biomechanical derangements of the diabetic foot: Charcot joint disease and limitation of joint motility
  • 1.9 Plantar pressure abnormalities in diabetic peripheral neuropathy
  • 1.10 Diabetic peripheral neuropathy and structural changes in bones, joints, and soft tissues
  • References
  • Chapter 2. Diabetes and Charcot neuroarthropathy: pathophysiology
  • Abstract
  • 2.1 Diabetes: definition and general considerations
  • 2.2 Pathophysiology of diabetes mellitus type 1 and type 2
  • 2.3 Diabetes-induced Charcot neuroarthropathy
  • 2.4 Charcot foot syndrome versus Charcot neuro-osteoarthropathy or Charcot neuropathic-sarco-osteoarthropathy
  • 2.5 Theories of Charcot neuroarthropathy: the German theory and the French theory
  • 2.6 Prevalence of Charcot neuroarthropathy
  • 2.7 Conditions that influence the advent of Charcot neuroarthropathy
  • 2.8 Symmetrical and asymmetrical neuropathy in relation to Charcot neuroarthropathy
  • 2.9 Autonomic neuropathy and neuropathic edema
  • 2.10 Nondiabetic conditions producing Charcot foot or Charcot neuroarthropathy
  • 2.11 Complications of Charcot neuroarthropathy (bones and soft tissues)
  • 2.12 Complications affecting soft tissues
  • 2.13 Signs of remission and recurrence of Charcot neuroarthropathy
  • 2.14 Role of imaging in Charcot neuroarthropathy
  • 2.15 Differential diagnosis or common conditions that resemble Charcot neuroarthropathy
  • 2.16 Prognosis of Charcot neuroarthropathy
  • 2.17 Conclusion
  • References
  • Chapter 3. Epidemiology and socioeconomic impact of diabetes and Charcot neuroarthropathy
  • Abstract
  • 3.1 Introduction
  • 3.2 Diabetes mellitus type 2: epidemiology and prevalence worldwide
  • 3.3 Diabetes mellitus type 2: effect of rapid economic development and modernization
  • 3.4 Prevalence of diabetes mellitus type 2 in some countries
  • 3.5 Common risk factors for diabetes mellitus type 2 complications
  • 3.6 General costs of diabetes mellitus type 2 in the United States
  • 3.7 Diabetes-induced Charcot neuroarthropathy
  • 3.8 Risk factors for Charcot neuroarthropathy
  • 3.9 Foot ulcerations in Charcot neuroarthropathy
  • 3.10 Infection
  • 3.11 Cost of foot ulceration
  • 3.12 Foot amputation in Charcot neuroarthropathy
  • 3.13 Depression, anxiety, dementia, and sexual dysfunction in Charcot neuroarthropathy
  • 3.14 Life expectancy and mortality in Charcot neuroarthropathy
  • 3.15 Conclusion
  • References
  • Chapter 4. Charcot neuroarthropathy: historical analysis and characteristics
  • Abstract
  • 4.1 Charcot neuroarthropathy (the diabetic foot): definition and characteristics
  • 4.2 Historical perspectives of Charcot neuroarthropathy
  • 4.3 Epidemiology, incidence, prevalence, and ethnicity of diabetic foot disease
  • 4.4 Risk factors and disorders producing the Charcot Foot
  • 4.5 Development and presentation of Charcot neuroarthropathy: the theories (acute inflammation theory and neurotraumatic and neurovascular theory) and predisposing factors
  • 4.6 Clinical presentation and distribution of Charcot involvement and the concept of “vicious cycle” and equinus deformity of the Charcot foot
  • 4.7 Stages of Charcot neuroarthropathy
  • 4.8 Classifications of Charcot neuroarthropathy based on anatomic locations: a meta-analysis
  • 4.9 New classification: a proposed classification based on anatomy, biomechanics, and magnetic resonance imaging findings in bones and soft tissues
  • References
  • Chapter 5. Normal bone, bone deformity, and joint dislocation in Charcot neuroarthropathy
  • Abstract
  • 5.1 Normal bone: infrastructure and biomechanical properties of bone
  • 5.2 Biomechanical properties of bone
  • 5.3 Loading and off-loading of the ankle-foot unit: generalities
  • 5.4 Loading and off-loading of the foot in diabetes
  • 5.5 Pathomechanics of the midfoot: mechanism of bone deformity
  • 5.6 Joint dislocations in Charcot neuroarthropathy
  • 5.7 Diagnostic imaging
  • 5.8 Complications of Lisfranc dislocation
  • 5.9 Toe deformities
  • 5.10 Second ray syndrome
  • References
  • Chapter 6. Biomechanical behavior of bone. Fractures in Charcot neuroarthropathy
  • Abstract
  • 6.1 The normal bone: biomechanical characteristics
  • 6.2 Bone elasticity: cortical bone versus trabecular bone
  • 6.3 Biomechanical behavior of bone: role of the bone matrix
  • 6.4 Muscular activity and effects on bone
  • 6.5 Bone geometry and effects on biomechanical behavior
  • 6.6 Bone changes with aging: deterioration of intrinsic and extrinsic resistance
  • 6.7 Changes in trabecular bone with aging
  • 6.8 Bone remodeling: mechanism and characteristics
  • 6.9 Diabetes type 2: effects on bone infrastructure
  • 6.10 Fractures of the ankle–foot unit in diabetes mellitus
  • 6.11 Stress fractures of the ankle–foot unit
  • 6.12 DMT2 therapeutics and effects on bones
  • References
  • Further reading
  • Chapter 7. Osteomyelitis in Charcot neuroarthropathy
  • Abstract
  • 7.1 Osteomyelitis: definition and history
  • 7.2 Osteomyelitis: clinical characteristics and risk factors
  • 7.3 Ulceration and osteomyelitis
  • 7.4 Diagnosis of osteomyelitis in Charcot neuroarthropathy
  • 7.5 Osteomyelitis versus Charcot neuroarthropathy
  • 7.6 Osteomyelitis: generalities and pathogenesis in diabetes-related Charcot neuroarthropathy
  • 7.7 Imaging of osteomyelitis in Charcot neuroarthropathy
  • References
  • Chapter 8. Differential diagnosis in Charcot neuroarthropathy
  • Abstract
  • 8.1 Introduction
  • 8.2 Common inflammatory conditions that resemble Charcot neuroarthropathy
  • 8.3 Rheumatoid arthritis and Charcot neuroarthropathy
  • 8.4 Osteoarthritis, diabetes, and Charcot neuroarthropathy
  • 8.5 Gout and Charcot neuroarthropathy
  • 8.6 Psoriasis arthritis and Charcot neuroarthropathy
  • 8.7 Pseudogout and Charcot Neuroarthropathy
  • 8.8 Infectious conditions that resemble diabetes-induced Charcot neuroarthropathy
  • 8.9 Human immunodeficiency virus infection and Charcot neuroarthropathy
  • 8.10 Nondiabetic conditions with underlying neurogenic arthropathy
  • 8.11 Covid-19 infection and diabetes
  • References
  • Further reading
  • Chapter 9. The articular cartilage: biomechanics and damage in diabetes-induced Charcot neuroarthropathy
  • Abstract
  • 9.1 Introduction
  • 9.2 Articular cartilage: function, composition, and structure
  • 9.3 Biomechanical behavior of articular cartilage
  • 9.4 Biomechanics of cartilage degeneration
  • 9.5 Metabolism of the cartilage: role of the chondrocytes
  • 9.6 The link between diabetes and osteoarthritis
  • 9.7 Risk factors for diabetes mellitus type 2 and osteoarthritis
  • 9.8 Effects of diabetes mellitus type 2 and hyperglycemia on cartilage
  • 9.9 Effects of diabetes mellitus type 2 and hyperglycemia on tendons and ligaments
  • 9.10 Relevance of the triad: diabetes, arthritis, and obesity
  • 9.11 Diabetes, osteoarthritis, and subchondral bone lesion
  • 9.12 Diabetes and association with loss of cartilage and impairment of fracture repair
  • 9.13 Magnetic resonance imaging of articular cartilage
  • References
  • Chapter 10. The skin: anatomy and pathologies in diabetes
  • Abstract
  • 10.1 Introduction
  • 10.2 Layers of the skin
  • 10.3 Blood supply to the skin of ankle and foot
  • 10.4 Innervation of the skin of the ankle-foot unit
  • 10.5 Skin diseases in diabetes: prevalence and pathogenesis
  • 10.6 Skin ulceration
  • 10.7 Sinus tracts
  • 10.8 Diabetic blisters (bullosis diabeticorum)
  • 10.9 Callus and corns
  • 10.10 Skin xerosis
  • 10.11 Eruptive xanthomatosis
  • 10.12 Madura foot (mycetoma)
  • References
  • Further reading
  • Chapter 11. Plantar subcutaneous fat pad and Kager fat pad and changes in Charcot neuroarthropathy
  • Abstract
  • 11.1 The foot fat pads: generalities
  • 11.2 The plantar fat pad: function, anatomy, and histology
  • 11.3 Biomechanics of the plantar fat pad
  • 11.4 Plantar fat pad and pressure distribution
  • 11.5 Plantar fat pad atrophy: causes and pathophysiology
  • 11.6 Effects of diabetes and hyperglycemia on the plantar fat tissue
  • 11.7 The calcaneal fat pad
  • 11.8 Diabetes mellitus type 2-related lesions in the plantar fat pad
  • 11.9 The Kager fat pad
  • References
  • Chapter 12. The plantar aponeurosis: anatomy, pathomechanics, imaging, and pathologies related to Charcot neuroarthropathy
  • Abstract
  • 12.1 The plantar aponeurosis: anatomy
  • 12.2 MR anatomy of the plantar aponeurosis: relationship with adjacent structures
  • 12.3 Pathomechanics of plantar aponeurosis
  • 12.4 Pathologies of plantar aponeurosis in relation with diabetes and Charcot neuroarthropathy
  • 12.5 Plantar fibromatosis
  • References
  • Chapter 13. The intrinsic and extrinsic muscles: anatomy and pathologies in diabetes-related Charcot neuroarthropathy
  • Abstract
  • 13.1 The intrinsic plantar foot muscles
  • 13.2 The extrinsic muscles
  • 13.3 Pathomechanics of the foot muscles
  • 13.4 Pathologies of the muscles in diabetes-related Charcot neuroarthropathy
  • 13.5 Conclusion
  • References
  • Further reading
  • Chapter 14. The Achilles tendon: anatomy biomechanics and changes in Charcot neuroarthropathy
  • Abstract
  • 14.1 Introduction
  • 14.2 Achilles tendon anatomy
  • 14.3 Biomechanics of the Achilles tendon
  • 14.4 Pathologies of the Achilles tendon
  • References
  • Chapter 15. The tendons and ligaments of the ankle-foot unit, the tarsal tunnel, the sinus tarsi, fascial compartments of the ankle-foot unit, and changes seen in Charcot neuroarthropathy
  • Abstract
  • 15.1 Introduction
  • 15.2 The tendons of the ankle-foot unit
  • 15.3 Imaging considerations
  • 15.4 Tendon pathology (tendinosis, tear, and tenosynovitis)
  • 15.5 Pathophysiology of tendon disease in diabetes and Charcot neuroarthropathy
  • 15.6 Tendinosis
  • 15.7 Tenosynovitis
  • 15.8 Tendon rupture
  • 15.9 The ligaments of the ankle-foot unit
  • 15.10 The tarsal tunnel
  • 15.11 The sinus tarsi
  • 15.12 Fascial compartments of the ankle-foot unit
  • References
  • Further reading
  • Chapter 16. The synovium and bursae of the ankle-foot unit: anatomy and pathologies in Charcot neuroarthropathy
  • Abstract
  • 16.1 The synovium
  • 16.2 The synovial joints and the functions of the synovium
  • 16.3 The synovium and the tendon: functions of the synovium
  • 16.4 Pathologies of the synovium at the ankle-foot unit
  • 16.5 The bursa
  • 16.6 Pathology of the bursa: imaging
  • References
  • Further reading
  • Chapter 17. The vascular system of the ankle-foot unit: anatomy and pathologies in Charcot neuroarthropathy
  • Abstract
  • 17.1 Anatomy of the vascular system of the ankle-foot unit
  • 17.2 Pathologies of the vascular system
  • 17.3 Role of imaging in peripheral arterial disease
  • 17.4 Monckeberg’s arteriosclerosis
  • 17.5 Muscle infarction in diabetic foot
  • 17.6 Necrosis in Charcot neuroarthropathy
  • References
  • Chapter 18. The nervous system: innervations of the skeleton; bone homeostasis; and peripheral neuropathies (Baxter’s neuropathy, tarsal tunnel syndrome, and peroneal neuropathy)
  • Abstract
  • 18.1 Introduction
  • 18.2 The nervous system and innervations of the skeleton
  • 18.3 The peripheral nervous system: somatic innervation of bones
  • 18.4 Peripheral nervous system: autonomic (sympathetic and parasympathetic) innervation of bones
  • 18.5 Characteristics of the skeleton and regulation of bone homeostasis
  • 18.6 Autonomic innervation of the bone marrow
  • 18.7 The bone marrow niche
  • 18.8 Clinical relevance of diabetic autonomic neuropathy
  • 18.9 Diabetic peripheral neuropathy and bone disease
  • 18.10 Influence of the peripheral nervous system on bone growth, fracture healing, denervation, and heterotopic bone formation
  • 18.11 Pathophysiology of bone pain
  • 18.12 Peripheral neuropathies of ankle-foot unit: Baxter’s neuropathy, tarsal tunnel syndrome, and peroneal neuropathy
  • 18.13 Peroneal neuropathies
  • 18.14 Conclusion
  • References
  • Chapter 19. The surgical management of the Charcot foot: physical examination of the foot prior to surgery, indications and criteria for amputation, and surgical techniques
  • Abstract
  • 19.1 Examination of the Charcot neuropathic foot
  • 19.2 Current conservative management of Charcot neuropathic foot
  • 19.3 Indications and criteria for surgery
  • 19.4 Current surgical management of Charcot neuropathic foot
  • 19.5 Amputation
  • 19.6 Conclusion
  • References
  • Chapter 20. The operated Charcot foot: biomechanics of the operated foot and foot ulcerations and their management
  • Abstract
  • 20.1 Biomechanics of the operated foot
  • 20.2 Ulcerations: management and follow-up
  • 20.3 Preventive measures for Charcot foot deformity: the role of footwear
  • 20.4 Complications of the deformed Charcot foot
  • 20.5 Surgical management of the deformed Charcot foot: rehabilitation
  • 20.6 Psychosocial implications of the Charcot foot
  • References
  • Chapter 21. The surgical approach and follow-up of the complicated Charcot foot: general considerations
  • Abstract
  • 21.1 Physical examination of the Charcot neuroarthropathic foot (diabetic foot)
  • 21.2 Classifications
  • 21.3 Current conservative management of Charcot neuropathic foot, diabetic foot infections, and preventative measures for skin ulcerations
  • 21.4 Risk factors for diabetic foot ulcers
  • 21.5 Indications and criteria for surgery and amputation
  • 21.6 Surgical management of the infected diabetic foot and surgical techniques and prognosis
  • 21.7 Surgical management of the deformed Charcot foot: postsurgical recovery and rehabilitation
  • 21.8 Future nonoperative developments and surgical techniques
  • 21.9 Imaging techniques
  • 21.10 Diabetic foot ulcers: new debridement methods and wound healing strategies
  • References
  • Further reading
  • Chapter 22. Imaging modalities in Charcot neuroarthropathy: indications and usefulness
  • Abstract
  • 22.1 Introduction
  • 22.2 Radiography: indications
  • 22.3 Ultrasonography: indications in Charcot neuroarthropathy
  • 22.4 Computed tomography: indications in Charcot neuroarthropathy
  • 22.5 Nuclear medicine: use in Charcot neuroarthropathy
  • 22.6 Magnetic resonance imaging in Charcot neuroarthropathy
  • 22.7 Magnetic resonance imaging: protocol and indications
  • References
  • Chapter 23. Considerations of different imaging techniques in the evaluation of Charcot neuroarthropathy (MR spectroscopy, MR diffusion tensor imaging-tractography, MR elastography, and positron emission tomography/magnetic resonance imaging)
  • Abstract
  • 23.1 Introduction
  • 23.2 Ultrasonography (Doppler, tractography) in Charcot neuroarthropathy
  • 23.3 Dual-energy spectral computed tomography and positron emission tomography computed tomography in Charcot neuroarthropathy
  • 23.4 Nuclear imaging in Charcot neuroarthropathy
  • 23.5 Advanced MR techniques in Charcot neuroarthropathy
  • 23.6 Magnetic resonance imaging of skeletal muscle: qualitative and quantitative techniques (MR spectroscopy, MR diffusion tensor imaging-tractography, MR elastography, and positron emission tomography/magnetic resonance imaging)
  • 23.7 Areas of research needed in the future
  • References
  • Index

Product details

  • No. of pages: 560
  • Language: English
  • Copyright: © Elsevier 2022
  • Published: May 11, 2022
  • Imprint: Elsevier
  • Paperback ISBN: 9780323993524
  • eBook ISBN: 9780323995788

About the Author

Claude Pierre-Jerome

Claude Pierre-Jerome MD, PhD, JM has over 40 years of experience in Radiology and research including diabetes, skeletal muscle and bone marrow. Author of several publications in International Journals. Co-author of five books in Radiology. Reviewer for US and European Journals. Author of two novels. He’s a member of several Medical Associations and fluent in English, French, Spanish and Norwegian. He was the visiting Associate Professor in University of Rochester, New York and worked as Faculty and Director of International Exchange Program for the Musculoskeletal Division at Emory University School of Medicine, Atlanta GA, USA. Presently he is working at the Akershus University Hospital in Oslo, Norway.

Affiliations and Expertise

Associate Research Professor, Oslo University Hospital, Oslo, Norway

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