Charcot arthropathy of the diabetic foot in a sub-Saharan tertiary hospital: a cross- sectional study
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
BioMedical Central
Abstract
Abstract
Background: Charcot foot arthropathy is a potentially limb-threatening condition that leads to progressive
destruction of the bones and joints in the neuropathic foot. One of its main causes is diabetes mellitus whose
prevalence is steadily increasing. The acute phase is often misdiagnosed thus leading to foot deformity, ulceration
and increased risk of amputation. There is a paucity of literature on this condition from sub-Saharan Africa. This
study aimed at determining the extent of Charcot foot arthropathy, the radiological patterns of Charcot foot
arthropathy and patient’s factors associated with Charcot foot arthropathy among adult patients with longstanding
diabetes in an African setting.
Methods: This was a cross-sectional study that was carried at a national referral and university teaching hospital in
Kampala, Uganda. One hundred patients with longstanding diabetes mellitus were consecutively recruited. Patients
with a history of having diabetes mellitus for at least seven years since diagnosis were considered to have
a longstanding disease. Clinical assessment of both feet was done. Weight-bearing radiographs of the selected foot
were taken and evaluated using the Sanders and Frykberg and modified Eichenholtz classifications. A blood sample
was taken for glycosylated haemoglobin (HbA1c). Data were summarized using descriptive statistics and student t-test.
Results: The proportion of Charcot foot arthropathy among patients with longstanding diabetes was 12% of which
one-third (4 out of 12) were acute cases. Fifty percent of the lesions were in the forefoot and 50% in the midfoot.
Seventeen percent of lesions were at the inflammatory stage of the modified Eichenholtz classification, 50% at the
developmental stage, 25% at the healing stage, and 8% at the remodelling stage. An abnormal foot radiograph was
significantly associated with Charcot foot arthropathy among patients with longstanding diabetes.
Conclusion: Charcot foot arthropathy is fairly common in patients with longstanding diabetes mellitus in these
settings with one third of patients presenting in the early acute phase. An abnormal weight-bearing radiograph was an
associated factor of Charcot foot arthropathy among this specific group of patients. To reduce on the morbidity and
limb threatening sequelae of this condition, clinicians are therefore advised to routinely examine the feet of patients
with diabetes and send those with suspicious signs and symptoms for radiographic assessment.
Description
Keywords
Charcot foot arthropathy, Diabetic foot, Sub-Saharan
Citation
Wanzou, J. P. V., Sekimpi, P., Komagum, J. O., Nakwagala,F., & Mwaka, E. S. (2019). Charcot arthropathy of the diabetic foot in a sub-Saharan tertiary hospital: a cross- sectional study. BioMedical Central: Journal of Foot and Ankle Research, 12:33. https://doi.org/10.1186/s13047-019-0343-0