Endocrine Abstracts

Background and aims: Charcot neuroarthropathy (CN) is a devastating and destructive disease of the bone structure and joints. Despite the fact that its description was published almost 130 years ago, its pathophysiology, risk factors, diagnosis, and treatment remain areas that need to be described. This study aims to describe patient characteristics and comorbidities as well as the clinical and morphological characteristics of these neuroarthropathies.

Material and methods: This is a retrospective and prospective study of 35 patients with neuro-arthropathy among patients hospitalized in our department between 2002 and 2022. Data for sex, age, diabetes type, duration, complications and treatement as well as the anatomical classification, stage of CN, diabetic foot ulcer, Hba1c were collected.

Results: 35 patients aged 56 years on average, were included. Patients are mostly type 2 diabetics (79%), aged 56 on average, male (66%) and overweight (average BMI 27.57 kg/m²). Diabetes is of long evolution (17 years on average) with poor glycemic control (average Hba1c at 9.39%), insulin-requiring (83%) and presents multiple micro and macrovascular complications (diabetic neuropathy 100%, diabetic retinopathy 83%). The majority of neuroarthropathies are chronic (79%), with acute cases (21%) being rarely diagnosed in time. An ulcer is revealing in nearly half of the cases (51%). Midfoot involvement is classically the most frequent: Type 2 (31%), Type 3 (17%). We observed a large number of simultaneous attacks on several areas. The radiological stages were as follows: Stage 0 (3%), Stage 1 (14%), Stage 2 (14%), Stage 3 (69%). MRI is performed in 41% of cases: grade 1 (4%), grade 3 (10%), grade 4 (17%), grade 5 (10%).

Conclusion: Charcot’s foot constitutes a diagnostic and therapeutic challenge. Indeed, an early diagnosis makes it possible to avoid the installation of sometimes severe and disabling deformations.