Background: The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. Introduction: The present review provides a concise account of the advances made over the last twenty-five years in understanding the pathogenesis and management of Charcot neuroarthropathy (CN). Methods: In this study, the widely known pathogenetic mechanisms underpinning CN are brought into focus, particularly the role of RANKL/RANK/OPG system and advanced glycation end production in the pathogenesis of CN. Furthermore, other potential triggering factors, namely nitric oxide, endothelial dysfunction, macro calcifications and body weight that influence CN have also been discussed. Results: The wide range of diagnostic tools available to clinicians for accurate staging of this pathology has been examined, particularly radiological and nuclear medicine imaging. Additionally, the difficult differential diagnosis between osteomyelitis and CN is also elucidated. Conclusion: The review concludes with the comprehensive summary of the major promising therapeutic strategies, including conservative treatment involving orthopedic devices, pharmacological approach, and the most common surgical techniques currently employed in the diagnosis and treatment of this acute disease.
Pitocco, D., Scavone, G., Di Leo, M., Vitiello, R., Rizzi, A., Tartaglione, L., Costantini, F., Flex, A., Galli, M. C., Caputo, S., Ghir-Landa, G., Pontecorvi, A., Charcot neuroarthropathy: From the laboratory to the bedside, <<CURRENT DIABETES REVIEW>>, 2020; 16 (1): 62-72. [doi:10.2174/1573399815666190502121945] [http://hdl.handle.net/10807/171123]
Charcot neuroarthropathy: From the laboratory to the bedside
Pitocco, Dario;Di Leo, Mauro;Vitiello, Raffaele;Rizzi, Alessandro;Tartaglione, Linda;Flex, Andrea;Galli, Maria Cristina;Caputo, Salvatore;Pontecorvi, Alfredo
2020
Abstract
Background: The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. Introduction: The present review provides a concise account of the advances made over the last twenty-five years in understanding the pathogenesis and management of Charcot neuroarthropathy (CN). Methods: In this study, the widely known pathogenetic mechanisms underpinning CN are brought into focus, particularly the role of RANKL/RANK/OPG system and advanced glycation end production in the pathogenesis of CN. Furthermore, other potential triggering factors, namely nitric oxide, endothelial dysfunction, macro calcifications and body weight that influence CN have also been discussed. Results: The wide range of diagnostic tools available to clinicians for accurate staging of this pathology has been examined, particularly radiological and nuclear medicine imaging. Additionally, the difficult differential diagnosis between osteomyelitis and CN is also elucidated. Conclusion: The review concludes with the comprehensive summary of the major promising therapeutic strategies, including conservative treatment involving orthopedic devices, pharmacological approach, and the most common surgical techniques currently employed in the diagnosis and treatment of this acute disease.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.