• Title/Summary/Keyword: Neuropathic arthropathy

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Surgical Management of Neuropathic Arthropathy due to Rheumatoid Arthritis: A Case Report (류마티스 관절염 환자에서 발생한 신경병성 관절병증의 수술적 접근: 증례 보고)

  • Hyunkyu Yu;Jaewon Kim;Sunghyun Lee
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.3
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    • pp.107-110
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    • 2024
  • Neuropathic arthropathy (Charcot arthropathy) is a progressive joint disease often associated with conditions such as diabetes, leading to severe joint deformity and pain. However, its occurrence in patients with rheumatoid arthritis (RA) is rare and not well documented. This case report describes a 48-year-old woman with a long history of RA who developed a severe deformity of her right ankle, identified as neuropathic arthropathy extending to the subtalar joint (Brodsky classification type 3A). After excluding other potential causes, the condition was determined to be secondary to RA-associated peripheral neuropathy. Surgery, including allograft and autograft fixation, was performed to correct the deformity. Post-operative complications, such as wound infection, were treated with negative pressure wound therapy and skin grafting. At the 18-month follow-up, the patient was able to walk without pain, demonstrating successful joint fusion.

Natural History of the Calcaneal Avulsion Fracture in Neuropathic Arthropathy in a Young Diabetic Patient (A Case Report) (젊은 당뇨 환자에서 신경병성 관절병증 종골 견열 골절의 자연 경과(1예보고))

  • Ko, Young-Chul;Eun, Il-Soo;Jung, Chul-Young;Kim, Jin-Wan;Choi, Hyeon-Soo;Kim, Ok-Gul
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.230-233
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    • 2008
  • The avulsion fracture of the calcaneal tuberosity is rare injury. Usually, it occurs from indirect trauma in old patients with osteoporosis or in patients with diabetic neuropathy. Especially, the bone and joint damage occurred in active patient with severe sensory loss or arthropathy related to nerve damage regardless of the cause is referred to neuropathic arthropathy. Generally, a patient with nondisplacement or minimally displacement is treated by conservative therapy and a patient with severe displacement is treated by open reduction and internal fixation. We experienced a 33 years-old woman with diabetes mellitus who had the displaced avulsion fracture of the calcaneal tuberosity without significant trauma and did not treat. We report upon this case at the 2 years follow-up.

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Neuropathic Arthropathy of the Shoulder Associated with Cervical Syringomyelia: A Case Report

  • Park, Jaehyun;Im, Taekang;Moon, Jinsun;Lee, Yongbeom
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.261-265
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    • 2015
  • Neuropathic shoulder arthropathy or Charcot's shoulder is an extremely rare disease, and sometimes it is associated with cervical syringomyelia. Clinical symptoms of the disease include edema of the shoulder and restriction in range of motion. Radiological diagnosis can be made through plain radiography through a characteristic, atrophic destruction of the joint. We experienced a Charcot's joint of the shoulder wherein destruction of the joint progressed extremely quickly and reviewed the literature concerning this condition.

Treatment of Diabetic Charcot Arthropathy (당뇨병성 샤콧 관절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.243-250
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    • 2013
  • Diabetic Charcot arthropathy is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, limb loss. Although recent research has improved our level of knowledge regarding its etiology and treatment, it still remains a poorly understood disease. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus and its diagnosis is commonly missed upon initial presentation. Clinicians treating diabetic patients should be vigilant in recognizing early signs of acute Charcot arthropathy, such as pain, warmth, edema, or pathologic fracture in a neuropathic foot. Early detection and prompt treatment can prevent joint and bone destruction. If left untreated, it can reduce overall quality of life and dramatically increase morbidity and mortality of patients. The goal of this manuscript is to evaluate the current concepts of Charcot arthropathy through review of various literature and help clinicians decide the treatment strategy.

Charcot Spinal Arthropathy with Extensive Vertebral Body Destruction and Cerebrospinal Fluid Collection: A Case Report Mimicking Infective Spondylitis (척추체의 광범위한 파괴와 뇌척수액 축적이 동반된 샤르코 척추 관절병증: 감염성 척추염과 유사한 소견을 보이는 증례보고)

  • Cho, Kyu-Jung;Kim, Yeo-Ju;Kim, Young-Tae;Youn, Yung-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.348-353
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    • 2020
  • A 68-year-old man presented with a bed sore with pus discharge on lower back. Radiographs showed extensive destruction of the L4 vertebral body. Magnetic resonance imaging (MRI) showed fluid collection with an enhanced wall at the defect of the L4 vertebral body extending into both psoas muscles. The primary diagnosis was neuropathic spondylopathy, but infective spondylitis was not ruled out. Initially, he was treated with antibiotics for two weeks. A follow-up MRI showed no improvement of the abscess, so surgical exploration was done. Charcot spinal arthropathy resulted in extensive vertebral body destruction that may be similar to infectious spondylitis, particularly in the case with fluid accumulation due to rupture of dura.

The Diagnosis and Treatment of Pain by using Thermography -Case report- (체열촬영술(Thermovision 782)을 이용한 통증의 진단과 치료 -증례 보고-)

  • Cho, Hee-Kyung;Park, Byung-Yong;Han, Neung-Hee;Lee, Won-Hyung;Kim, Hae-Ja;Park, Chan-Hee;Lee, June-Kyu
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.53-58
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    • 1994
  • Thermography has proven to be an effective way to monitor near-surface blood flow in the body, as well as detecting sensitive changes accompanying painful conditions. Thermography is a non-invasive technique free of biological hazards. It provides a comfortable method of diagnosis and evaluation for neuropathic disorder and its treatment. The following are 3 cases of neuropathic disorder and treatment with follow-up thermography.

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Congenital Insensitivity to Pain and Anhidrosis Masquerading as a Chronic Osteomyelitis of the Talus (A Case Report) (족관절부의 만성 골수염으로 오인된 유전성 감각 및 자율신경병증 제 4형 환아(1예 보고))

  • Shin, Yong-Woon;Chung, Hyung-Jin;Oh, Jong-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.203-206
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    • 2009
  • We experienced a case of congenital insensitivity to pain with anhidrosis mimicking a chronic osteomyelitis of the talus, with recurrent ankle swelling and intermittent fever. He was misdiagnosed as low virulence osteomyelitis at other hospital in annual recurrence for 3 years. A Charcot joint in children is a very rare condition and diagnosis should be made in a careful approach.

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The Importance of Treatment for the Patients with Chronic Pain (만성통증 환자 치료의 중요성)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.252-255
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    • 1999
  • Numbers of patients who have chronic pain seem to be increasing even in the psychiatric practice. One report in Korea showed more than 40% of psychiatric patients who visited out-patient clinic were suffered from chronic pain and one third of those patients were needed treatment for the on-going pain. For evaluating and treating those patients the charateristics of illness behavior should be understood. Abnormal Illness behavior was found as one of the most influential factors which led symptoms complicated and chronified. This symposium was planned to illustrate how to manage the patients whose pain are associated with arthropathy and connective tissue diseases, neuropathic pain and headache more effectively and efficiently. So, It is hoped to get fruitful knowledges for the management of chronic pain in the scope of consultation-liaison psychiatry.

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