Medical management of Charcot arthropathy
| Autor: | M. E. Edmonds, N. L. Petrova |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Calcitonin
Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Time Factors Pharmacological therapy Endocrinology Diabetes and Metabolism Bone healing Severity of Illness Index Bone remodeling Weight-Bearing Endocrinology Diabetes mellitus Arthropathy Internal Medicine medicine Humans Major complication Intensive care medicine Diphosphonates business.industry medicine.disease Clinical trial Casts Surgical Diabetes Mellitus Type 1 Early Diagnosis Diabetes Mellitus Type 2 Parathyroid Hormone Physical therapy Disease Progression Human Parathyroid Female Arthropathy Neurogenic business Skin Temperature |
| Zdroj: | Diabetes, obesitymetabolism. 15(3) |
| ISSN: | 1463-1326 |
| Popis: | Charcot arthropathy is a major complication of diabetes and it poses management challenges to health care professionals. Early diagnosis and timely intervention are essential for improved outlook of these patients. Casting therapy has been accepted as the mainstay treatment of the acute Charcot foot, although there are still controversies regarding its duration, the choice of removable and non-removable device and weight-bearing casts vs. non-weight-bearing casts. Two groups of antiresorptive therapies have been evaluated in the treatment of the acute Charcot foot, bisphosphonates (intravenous and oral) and calcitonin. These therapies have clearly shown a reduction of bone turnover, although, they have not shown a significant effect on temperature reduction. Current evidence to support their use is weak. An anabolic agent to speed up clinical resolution and fracture healing may be helpful and a clinical trial to evaluate the possible benefit of 1–84 recombinant human parathyroid hormone on fracture healing in the acute Charcot foot is in progress. This paper summarises the current approach to medical management of acute Charcot arthropathy with specific emphasis on casting and pharmacological therapy. Emerging new studies of the pathogenesis of this condition are also discussed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text