Nbr - Charcot Foot Deformity

Front 1

Provide five synonyms for Charcot foot

Back 1

Neuropahtic ostoearthropathy, dibetic neuroarthropathjy, Charcot's arthropathy, neuropathi arthropathy.

Front 2

Defien Charcot joint disease

Back 2

Charcot constitues a highly destructive and relatively painless disorder that involves singular or mutiple joints.

Front 3

What is the original diosrder associated with charcot joint diseae?

Back 3

Jean Martin Charot in 1868 described neruopathic joint chainges in paietns with tabes dorsalis (tertiary syphilis)

Front 4

What is the current disorder assciated with Charcot joint diseae?

Back 4

diabetes mellitus

Front 5

Name the four most common disorders with poetietnial for nerupathic osteoarthropathy.

Back 5

diabiets mellitus, tertiary syphilis, leprosy, and syingomyelia

Front 6

Beside the four most commo disorders relatred with Charcot joint disase , name tenother poetenial cuases

Back 6

spina bifieda, memngomyelocele, congential insentivity to pain, hysterical insentivity to pain, chronic alchoholism, peripheral nerve injury, sicateic nerve everance, spinal cord njury, melodyspalsia, polimelitis, multiple scerosis, Rile-Day syndrome, intra-articular injections, and paraplegia

Front 7

Name four disease casuing neuroapthic osteorarthropathy with predilection fo rthe foot and ankle.

Back 7

Diabetes mellitus, leprosy, menigomyelocele, and congentialinsentistivyt to pain.

Front 8

What is the pathogenesis for Charcot joint diseae?

Back 8

alhtough unclear it is multifactoril. Two theroies attributed o th e pathgenesis are th enurotraumatic and neurvascualr reflex theory. The former relies on neruoparhyt and repeated trauma, which procese the eventual joint destruciton. The latter propposes increased perpheral blod flow form autoonomic neuropathy, which fresults in abudnant bone resorption.

Front 9

Whor provided the radigraphic staging usedin neuropathic osteoarthropathy/ describe hte stages

Back 9

Theradiographic stages of DEVELPMENT, COALESCENCE, and RECONSTRUCTION wre described by Eichenholtz in 1966. The development stage has intial destruction consisting of jointlaxity, subluxation, osteochondral fragmentation and debrisformation. The coasexence has absroption of debris ad fuison of fragments to adjacent obne. The stage of reconstrucgtion increase stabilization by trabecualr remodeling, osseous proliferation and ankylosis.

Front 10

What are the clinical featursw fo an acute chracot deformity?

Back 10

The classic findings involve he vascualr , nueropathic, skeletal ,and cutaneous asstaus of the paient. The pulses are usually boudnign with warmth, swelling, and erythema. There is alwyas soem degreeof neuropathy aiwth reduced or absent refelxes, proprioception, vibratory sens, and/or pain. Autonomic neruopathy in the form of anhydrosis is seen. The skeletal system provides hypermobility and crepitus resulting in some pedal deformity suh as rocke bottom. The severity of the seltal deformity allows cutaneous lesiosn such as hyperkeratoses or ulcerations, which creathe the potential for infection.

Front 11

Name five differential diganoses ofr Charcot joint disease.

Back 11

Acute septic arthritis, gout, rheumatiod arthritis, psoiratic arthritis, osteorarthritis, tuberculous arthitis, paraplgia, and neoplasms.

Front 12

What is the mainstay for treatment of acue neuropathic arthropathy?

Back 12

consevative therapy by cessation of weightberaing of the involved extremity in order to prevent fther destruction.

Front 13

What is the Sanders classification of neuropathic osteorarthropathy?

Back 13

Sanders and MRdjecovich describe the Charcot Patterns base upon the location in diabetic paients.
Pattern I: forefoot
Pattern II: tarsometatrasrals
Pattern III: Midtarasal nd naviculocuneiform
Pattern IV: ankle and sbtal joint
Pattern V: calcaneus (posterior pillar)

Front 14

Which pattern of the sanders classfication may in fact not be neruopathic osteorthropathy?

Back 14

Pattern V involves fractures of the calcaneus but does not involve any joints. THis has been referred to as a calcaneal insufficiency fracture or simply a neuropathic fracture.

Front 15

Name three immobilizers used it neh care of acute Charcot with deep ulceraiotn.

Back 15

Typically these are removale modalities ot allow dressing changes and clsoe inspection of the wound. A bivalve cast, CAM walker, or Charcot restrain orhtotic walker (CROW)

Front 16

What are the indications for surgical reconstruction of the Carcot foot?

Back 16

Marked instability and reclacitrant ulceration.

Front 17

What adjuncive procedure is usually perfomred with reafoot Charcot reconstructions?

Back 17

Commonly ht etendo chilles is lenghtened in order ot reduce the equinus deformity, which often exiss. Otherwise if the ankle isto be fureed then the release of the Achilles tendon allows greater ease achieving optimal psoitonig.

Front 18

What are the goasls of Charcot reconstruction?

Back 18

The goal is a plantirade foot with the ankle sat 90 degrees, the hidfot in 5-10 egrees of valugs rotation and external rotation equivalent ot the opoposite foot.