Abstract：
OBJECTIVE: To evaluate the real-life diagnosis and therapeutic means of Charcot Neuroosteoarthropathy (CN) in French-Belgian diabetic foot expert centers.
METHODS: We collected clinical characteristics, results of exams and therapeutic pathways of consecutive adult patients with diabetic osteoarthropathy seen in consultation or hospitalization from January 1 to December 31, 2019 in 31 diabetic foot expert centers. The primary outcome was to describe the diagnostic and management methods for CN according to patient clinical characteristics, the clinical-radiological characteristics of acute and chronic CN and discharge means.
RESULTS: 467 patients were included: 364 with chronic CN and 103 in the acute phase. 101 patients had bilateral chronic CN. Most patients were male (73.4%), treated with insulin (73.3%), and with multicomplicated diabetes. In the acute phase, edema and increased foot temperature were present in 75% and 58.3% of cases, respectively. Diagnosis confirmation was usually by MRI and the mode of discharge was variable. In the chronic phase, orthopedic shoes were prescribed in 81.5% of cases.
CONCLUSIONS: This observational study highlights the diagnostic and therapeutic practices in 31 diabetic foot centers. Our results highlight that the use of MRI and the modalities of offloading, an essential treatment in the acute phase, need to be better standardized. Centers were highly encouraging about creating a patient registry.
METHODS: We collected clinical characteristics, results of exams and therapeutic pathways of consecutive adult patients with diabetic osteoarthropathy seen in consultation or hospitalization from January 1 to December 31, 2019 in 31 diabetic foot expert centers. The primary outcome was to describe the diagnostic and management methods for CN according to patient clinical characteristics, the clinical-radiological characteristics of acute and chronic CN and discharge means.
RESULTS: 467 patients were included: 364 with chronic CN and 103 in the acute phase. 101 patients had bilateral chronic CN. Most patients were male (73.4%), treated with insulin (73.3%), and with multicomplicated diabetes. In the acute phase, edema and increased foot temperature were present in 75% and 58.3% of cases, respectively. Diagnosis confirmation was usually by MRI and the mode of discharge was variable. In the chronic phase, orthopedic shoes were prescribed in 81.5% of cases.
CONCLUSIONS: This observational study highlights the diagnostic and therapeutic practices in 31 diabetic foot centers. Our results highlight that the use of MRI and the modalities of offloading, an essential treatment in the acute phase, need to be better standardized. Centers were highly encouraging about creating a patient registry.
摘要：
目的：评估法国-比利时糖尿病足专家中心Charcot神经骨关节病（CN）的实际诊断和治疗方法。
方法：我们收集了临床特征，2019年1月1日至12月31日在31个糖尿病足专家中心咨询或住院的连续成年糖尿病性骨关节病患者的检查结果和治疗途径.主要结果是根据患者临床特征描述CN的诊断和管理方法，急性和慢性CN的临床放射学特征和出院手段。
结果：467例患者包括：364例慢性CN和103例急性期。101例患者有双侧慢性CN。大多数患者为男性（73.4%），用胰岛素治疗（73.3%），患有多种复杂的糖尿病。在急性期,75%和58.3%的病例出现水肿和足温升高，分别。诊断通常通过MRI确认，并且出院方式可变。在慢性期,81.5%的病例使用矫形鞋。
结论：这项观察性研究强调了31个糖尿病足中心的诊断和治疗实践。我们的结果强调了MRI的使用和卸载的方式，急性期的基本治疗，需要更好的标准化。中心对创建患者注册表非常令人鼓舞。
方法：我们收集了临床特征，2019年1月1日至12月31日在31个糖尿病足专家中心咨询或住院的连续成年糖尿病性骨关节病患者的检查结果和治疗途径.主要结果是根据患者临床特征描述CN的诊断和管理方法，急性和慢性CN的临床放射学特征和出院手段。
结果：467例患者包括：364例慢性CN和103例急性期。101例患者有双侧慢性CN。大多数患者为男性（73.4%），用胰岛素治疗（73.3%），患有多种复杂的糖尿病。在急性期,75%和58.3%的病例出现水肿和足温升高，分别。诊断通常通过MRI确认，并且出院方式可变。在慢性期,81.5%的病例使用矫形鞋。
结论：这项观察性研究强调了31个糖尿病足中心的诊断和治疗实践。我们的结果强调了MRI的使用和卸载的方式，急性期的基本治疗，需要更好的标准化。中心对创建患者注册表非常令人鼓舞。
