暂无摘要。

BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease.However, there are few cases of Charcot Neuro-osteoarthropathy (CN) caused by rheumatoid diseases in clinical reports. It is not easy to pay attention to the diagnosis of CN in the complications of rheumatoid disease, which greatly increases the probability of misdiagnosis and missed diagnosis. This case reported a rare complication of rheumatoid arthritis, Charcot arthritis, and the molecular mechanism and diagnosis and treatment of CN caused by RA were systematically discussed.
METHODS: The patient, a 79-year-old woman, was hospitalized due to bilateral shoulder pain, limited activity for half a year, aggravated for 4 months to the hospital. During this period, the symptoms did not improve after treatment with acupuncture and Chinese medicine. The patient was previously diagnosed with rheumatoid arthritis for more than 3 years and intermittent irregular use of methylprednisolone and methotrexate for 2 years. She had a history of osteoporosis.
METHODS: symmetrical malformed swelling of the finger joints of both hands; Bilateral supraspinatus and deltoid muscle atrophy, tenderness at the acromion, and attachment of the long head tendon of the biceps brachii were observed. The left Dugas test and the right Dugas test were positive.Blood test: anti-cyclic citrullinated peptide antibody (A-CCP) 33.10U/ml (normal range: 0-5RU/ml); antinuclear antibody quantification (ANA) 47.40AU/ml (normal range: Negative or < 32); anti-double stranded DNA IgG antibody quantification (dsDNA) 31.00 IU/ml (normal range: 0-100 IU/ml); D-Dimer 6.43 µg/ml (normal range: 0-0.5 mg/L); erythrocyte sedimentation rate (ESR) was 27 mm/h (normal range: < 20 mm/60 min). C-reactive protein (CRP) 39.06 mg/L(0.068-8 mg/L).MRI 3.0 T enhancement of bilateral shoulder joints, cervical spine and thoracic spine showed: 1.Large bone destruction, cartilage injury, multiple effusion, synovitis, obvious on the right side. 2.Intervertebral disc degeneration, cervical 3/4, 4/5, 5/6, 6/7 disc herniation, with cervical 3/4 obvious, posterior central herniation; CONCLUSIONS: Rheumatoid arthritis complicated with Charcot\'s joint is rare. Clinically, patients with rheumatoid diseases should not ignore Charcot\'s joint complications because of rareness. Early blood inflammatory markers, neuro electrophysiology, and imaging MRI of rheumatoid CN are of great significance for the diagnosis of this mild or early neurovascular inflammation. Early diagnosis and treatment are helpful to prevent further joint injury. The clinical diagnosis, treatment, and molecular mechanism of osteolysis in RA and peripheral sensory nerve injury remain to be further revealed.

UNASSIGNED: To summarize the progress of clinical diagnosis and treatment of diabetic Charcot neuroarthropathy (CNO) of foot and ankle to provide reference for clinical treatment.
UNASSIGNED: The research literature on diabetic CNO of foot and ankle at home and abroad was widely reviewed, and the stages and classification criteria of CNO were summarized, and the treatment methods at different stages of the disease course were summarized.
UNASSIGNED: CNO is a rapidly destructive disease of bone and joint caused by peripheral neuropathy, which leads to the formation of local deformities and stress ulcers due to bone and joint destruction and protective sensory loss, which eventually leads to disability and even life-threatening. At present, the modified Eichenholtz stage is a commonly used staging criteria for CNO of foot and ankle, which is divided into 4 stages by clinical and imaging manifestations. The classification mainly adopts the modified Brodsky classification, which is divided into 6 types according to the anatomical structure. The treatment of diabetic CNO of foot and ankle needs to be considered in combination with disease stage, blood glucose, comorbidities, local soft tissue conditions, degree of bone and joint destruction, and whether ulcers and infections are present. Conservative treatment is mainly used in the active phase and surgery in the stable phase.
UNASSIGNED: The formulation of individualized and stepped treatment regimens can help improve the effectiveness of diabetic CNO of foot and ankle. However, there is still a lack of definitive clinical evidence to guide the treatment of active and stable phases, and further research is needed.
UNASSIGNED: 总结足踝部糖尿病夏科神经性关节病（Charcot neuroarthropathy，CNO）的临床诊治进展，为临床治疗提供参考。.
UNASSIGNED: 广泛查阅国内外有关足踝部糖尿病CNO的研究文献，从CNO分期及分型标准、病程不同时期的治疗方法等方面进行总结。.
UNASSIGNED: CNO是一种因周围神经病变引起的骨关节急速破坏性疾病，因骨关节破坏和保护性感觉缺失导致局部畸形及应力性溃疡的形成，最终导致残疾甚至威胁患者生命。目前，临床常用的足踝部CNO分期标准是改良Eichenholtz分期，以临床和影像学表现分为4期；分型主要采用改良Brodsky分型，按解剖结构分为6型。足踝部糖尿病CNO治疗方法的选择需要结合分期、血糖、合并症、局部软组织条件、骨关节破坏程度、是否合并溃疡与感染等因素综合考虑。活动期主要采取保守治疗，稳定期主要采取手术治疗。.
UNASSIGNED: 制定个体化、阶梯化治疗方案有助于提高足踝部糖尿病CNO疗效。但目前仍缺乏确切的临床证据对活动期与稳定期的治疗进行指导，未来需要进一步研究。.

Charcot neuroarthropathy (CN) is a serious diabetic complication with a poor prognosis and a high rate of misdiagnosis. Furthermore, beta(2)-microglobulin amyloidosis (Abeta2M) makes the diagnosis and therapy more difficult and complex. This case report highlights the pathophysiology, clinical evaluation, treatment, and prevention of the major diabetic complications associated with CN and Abeta2M that cause poor quality of life, limit the patient\'s ability to walk independently, and are directly or indirectly linked with a high risk for lower limb amputation. Ankle CN was discovered in a 36-year-old single female with a history of type 1 diabetes mellitus and diabetic nephropathy. We performed early internal fixation. However, because she lived alone and needed hemodialysis three times a week, wearing a brace and non-weight-bearing were extremely inconvenient. Furthermore, she did not experience any pain and only some edema; thus, she proceeded to bear weight ahead of schedule without authorization. Due to the premature weight-bearing and poor compliance, the patient suffered severe bone resorption and infection and eventually had to undergo amputation. Abeta2M was suggested by bone pathological sections. We present a case of failed internal fixation of ankle CN with Abeta2M, emphasizing the importance of social factors and postoperative management.

暂无摘要。

Charcot arthropathy of the shoulder joint is usually referred to as shoulder joint involvement of Charcot arthropathy, which is a chronic, degenerative, destructive condition resulting from decreasing or loss of sensorial innervation. To date, several reports have described the shoulder Charcot arthropathy, caused by malformations of the occipital region with syringomyelia; but nobody has reported the shoulder Charcot arthropathy secondary to hemangioblastoma in conus medullari with syringomyelia. Therefore, we report a 32-year male patient who was diagnosed with Charcot arthropathy of the shoulder joint, which was misdiagnosed as a soft tissue tumor and treated surgically. After the operation, the whole-spine MRI examination was performed as a presenting feature of hemangioblastoma in conus medullari with syringomyelia. Key Words: Arthropathy, Neurogenic, Hemangioblastoma, Syringomyelia.

Charcot arthropathy is a type of destructive osteoarthropathy characterized by neurotrophic and sensory disorders. The condition is relatively rare, with an insidious onset, and it is easily misdiagnosed. Total knee arthroplasty (TKA) can cause excessive joint wear, continuous inflammatory stimulation of the prosthesis, postoperative residual cavity, prosthesis loosening and subsidence, peripheral fracture, infection, and other complications. Furthermore, these complications are more likely to occur in patients with Charcot arthropathy because of disease-specific pathological characteristics, when TKA is performed. Therefore, Charcot arthropathy was once a contraindication to TKA. Recently, with the optimization of joint prostheses and the maturity of surgical techniques, more studies have reported successful cases of TKA in patients with Charcot arthropathy. We report a case of Charcot arthropathy in our hospital, and describe the patient\'s medical history, clinical symptoms, signs, imaging findings, diagnosis, and the entire TKA process, to explore the TKA strategy and prosthesis selection in a patient with Charcot arthropathy.

UNASSIGNED: Charcot arthropathy, also known as neuropathic arthropathy, is a rare disease whose early diagnosis and treatment are very difficult. Generally, diabetes is considered the most common cause of Charcot arthropathy. Although Charcot arthropathy of other secondary etiology has been reported, in most cases only a single joint is accumulated, and rarely involving the feet and shoulders. Clinically, Charcot arthropathy due to delayed diagnosis leads to joint destruction and severe cases abound.
UNASSIGNED: What we report is an unprecedented case, in which the patient was diagnosed as left shoulder joint, interdigital joint Charcot arthropathy caused by cervical spondylotic myelopathy (CSM) and left knee and right ankle Charcot arthropathy caused by adult degenerative scoliosis (ADS) complicated by syringomyelia. The 82-year-old male patient was admitted to the hospital for complaining of pain in the left knee joint. Except for scoliosis that was discovered 10 years ago, the patient denied any other obvious past medical history. Clinical/surgical manifestations, detailed physical examinations and auxiliary examinations all indicated the presence of polyarticular Charcot arthropathy, but common causes of Charcot arthropathy such as diabetes and syphilis have not been detected. After making a comprehensive differential diagnosis, we finally made the above diagnosis.
UNASSIGNED: This previously unreported case describes the complexity and etiological diversity of Charcot arthropathy. We recommend that patients with CSM and/or scoliosis, spinal deformity undergo further examination and regular follow-up. A detailed medical history and careful physical examination are necessary for the correct diagnosis of Charcot arthropathy. Although the early diagnosis of Charcot arthropathy cannot change the natural course of the disease, it is beneficial to alleviate symptoms and prevent serious complications.

暂无摘要。

Charcot foot is a rare disease in clinic, its pathogenesis includes neurotrauma theory, neurovascular theory, comprehensive theory, and inflammatory factor theory. The disease is characterized by progressive joint and bone destruction of foot and ankle joint. Conventional X-ray examination is not sensitive to the early diagnosis of disease, the manifestation of CT and MRI of disease is characteristic and could be used to make a comprehensive evaluation of bone and soft tissue lesions of disease. It is not difficult to make a diagnosis based on characteristic findings of CT and MRI and clinical manifestations such as swelling, pain and skin temperature rising of foot and ankle. Charcot foot has multiple classification methods including anatomy, imaging and clinical classification. Improved Eichenholtz staging classification is most commonly used currently which could make a more comprehensive assessment of disease and guide treatment better. According to the stage of disease, treatment could be carried out including non-weight bearing and brace protection, drugs therapy and surgical treatment, etc. Early diagnosis, brace protection, could protect joint and delaying progression of deformity. There is no clear long-term and generally accepted conclusion about the efficacy of drug therapy. For advanced patients, surgical treatment must be actively performed to preserve a stable and functional ankle joint and reduce amputation rate.