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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Increased skin temperature in the foot has high sensitivity but low specificity.204 Charcot neuroarthropathy can mimic an injury or infection of the mid-foot, with increased warmth (2°C/3.6°F) being an early sign.205 Differences in skin temperature between the affected foot and the contralateral (non-affected) foot among patients with Charcot's neuroarthropathy can be detected well before other clinical signs emerge.206
Movement disorders
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
v – Charcot-Marie-Tooth disease. Charcot-Marie-Tooth disease is also known as hereditary motor and sensory neuropathy. It has a prevalence of 1 in 2500, making it one of the commonest inherited neurological diseases (usually autosomal dominant, although X-linked and recessive variants do exist). The usual symptoms include a progressive distal weakness of muscles and atrophy (hence the description ‘inverted champagne bottles’), high-arched foot deformities, distal sensory loss and hyporeflexia.1
Management of diabetic foot
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Venu Kavarthapu, Raju Ahluwalia
The reconstruction of a foot affected by CN is one of the most challenging surgical interventions. A deformed Charcot foot is often limb threatening, particularly in the presence of an ulcer. The amputation risk is 7 times higher for diabetes patients with an ulcer and 12 times higher with Charcot and an ulcer (23). The surgical aim of Charcot foot reconstruction is to achieve a normal shaped, plantigrade and stable foot that allows full weight-bearing using routine or modified shoes. Long-term stability of the reconstructed foot requires full deformity correction and solid bone fusion of all bones that are intended for fusion. Vascular assessment prior to the deformity correction, and revascularisation if required, is critical for predictable bone union. Detailed clinical and radiological assessment of the bone and soft tissue components of the deformity is essential for a successful outcome.
Current concepts underlying the pathophysiology of acute Charcot neuroarthropathy in the diabetic foot and ankle
Published in Expert Review of Clinical Immunology, 2020
Thomas H. Yates, Steven R. Cooperman, David Shofler, Devendra K. Agrawal
The largest such study to date was recently published by Mrozikiewicz-Rakowska et al. Their 2018 study involved 77 Charcot patients, 243 non-Charcot diabetic subjects with neuropathy, and 986 non-diabetic controls. The authors identified significant differences among the frequencies in allele distribution among diabetic patients with symptomatic feet with respect to the genes encoding RANK, RANKL, and OPG. In particular, the variations among allele frequencies in the OPG gene were of particular interest as they belong to the TNF receptor superfamily, suggesting another potential link between the RANK/RANKL/OPG signaling and TNFα inflammatory pathways [47].
Neuro-urological sequelae of lumbar spinal stenosis
Published in International Journal of Neuroscience, 2018
Jason Gandhi, Janki Shah, Gargi Joshi, Sohrab Vatsia, Andrew DiMatteo, Gunjan Joshi, Noel L. Smith, Sardar Ali Khan
Results of physical examination are often unremarkable in patients with LSS. Nevertheless, review of the literature suggests that diminished lumbar extension appears most consistently, varies less and constitutes the most significant finding in LSS. Charcot joints may be present in long-standing disease, and radiculopathy may be noted with motor, sensory and/or reflex abnormalities. Previous studies have also noted that asymmetric muscle stretch reflexes and focal myotomal weakness with atrophy occur more with lateral recess than central LSS. Additionally, objective neurologic deficits may occur in approximately 50% of LSS cases [41].
The concepts of heredity and degeneration in the work of Jean-Martin Charcot
Published in Journal of the History of the Neurosciences, 2020
In particular, Charcot focused on hereditary predisposition as well as dissimilar heredity. For example, a young woman who suffered from hysteria in adolescence and from delirious ideas and mania in adulthood, eventually dying in a state of dementia. A morbid predisposition led to the successive exteriorization of “pathologies of the same kind, manifesting the same pathological aptitude of the degenerate race by various disturbances,” according to Morel. His doctrine, as Charcot understood it, took the form of a vast etiological concept situated at the foundation of all psychiatric and neurological diseases of the nervous system.