Endocrine Abstracts

Introduction: Diabetic osteoarthropathy or Charcot’s foot is a serious complication of diabetes whose early diagnosis is complex and often delayed. It manifests itself in the acute phase by localized inflammation of the foot or ankle, and in the absence of discharge, it leads to severe bone damage. Hence the need for better knowledge and early and adequate treatment.

Goal of the Study: The aim of our study is to describe a cohort of diabetic patients followed for acute Charcot foot.

Patients and Methods: Retrospective study over 3 years taking place from May 2019 to May 2022 at the CHU Ibn rochd. 28 records of patients followed for Charcot’s foot were collected, including 6 received in the acute phase. We describe the 6 patients followed for acute Charcot’s foot secondarily confirmed by imaging. Stabilization of Charcot’s foot was defined by the clinical disappearance of inflammatory signs.

Results: The average age of our patients was 51 years old, with a clear male predominance of 5/1 and an average BMI of 25.6 kg/m^². Type 2 diabetes predominated in 66.6% with an average duration of evolution of 14 years, the mean HbA1c was 9.7%. The injury was in the right foot in 83.3% of cases. The clinical elements reported were swelling in 100% of cases, warmth in 83.3% of cases, redness in 66.6% of cases, deformities were described in 33.3% of cases. The main triggering factors were unsuitable footwear in 50% of cases and trauma in 33.3% of cases. The mean time to diagnosis was 50 days. All the patients benefited during the initial phase from a strict discharge by circular fenestrated cast in 83.3% and by thermoformable splint in 16.6% of the cases then of a relay by orthopedic shoe in 100% of the cases. One patient received medical treatment with bisphosphonates. Stabilization was obtained in 83.3% of patients with an average delay of 274 days.

Conclusion: Acute Charcot’s foot is a rare but severe complication, difficult to identify, it is often underdiagnosed, causing delays in management and compromising the functional prognosis of the diabetic patient.