Diabetic Neuropathic Joint

Treatment Options for Charcot Foot Babak Kosari MD

Charcot foot is a neuropathic foot diseasethat is sometimes seen in patients with diabetes. The prevention of further joint destructionand foot deformity is the primary initial aim in treatment of charcot's foot. BabakKosari of Valley Presbyterian tells us about this disease and how critical itis to have it treated promptly and correctly. It's a condition that affects diabetics. Nowit's an end stage type of a condition where once you start developing a charcot foot,your disease process has gone on for a long time your neuropathy or lack of sensationin the lower extremity which is one of the conditions that happens with over 40% of diabetics.The bones in the foot, they start to demineralize.

In other words the calcium, the minerals,the get less and less the bone becomes weak and it starts to crack just by standing orwalking. Now if you have a minor trauma that exacerbates it. Eventually what happens, thearch of the foot starts to collapse and the foot changes the shape and then you developthis what's called technically quot;Bag of Bonesquot; and these are tiny fractures that happensin the bones of the foot of the diabetic patient. It's a very very serious condition when ithappens for a diabetic. In the initial phase, it goes untreated, unnoticed again primarilybecause the patient doesn't feel pain. The disease process is very complicated, thereare many theories about it. One of them is

that the nerve endings that supply sensationto the arteries, they don't function well. So the signal goes to open up the vesselsthe rush of blood comes into the foot and the rush of blood demineralizes the bone,weakens the bone. The treatment involves a team process we have a foot surgeon, we havethe vascular surgeon, we have the endocrinologist, primary physician, all these have to cometogether and develop a plan. The point is to prevent all this, once it happens the gamechanges. Then you get into first trying to stabilize this process because these bonesare breaking. The patient is walking, they're working, they're doing things they're weightbearing and they're not realizing that this

foot is actually collapsing slowly, slowly,slowly and if you take photographs from day one to day thirty, the drastic change in thefoot. This is not a reversible type of a condition. What we do is in severe cases, we do reconstructionof the foot. It's a very complicated surgery, it involves metal frames that go from thefoot to the leg. It's a long recovery and it has many facets to postop care and educationyou know education for a long term. The first preventative treatment for these types ofpatients is education. You want your patient to know about what to look for, they haveto have a comprehensive plan of care which routinely involves being checked by a footspecialist for types of foot changes that

normally we don't think about. For example:a small callus, you know we have calluses on our hands and our feet but that callusfor a diabetic patient underneath is a very significant finding underneath, what's happeningin the bones is very crucial. Xrays, different imaging studies, just watching the patientwalk, how they're walking, the biomechanics of the foot, the types of shoes that theywear, the type of activity, their lifestyle, all these come into effect and my biggestweapon against all this is educating my patient as to what to look for. It's a preventablecondition but it has to be caught early and education is the key. How many high schoolfootball players sustain a concussion each

year? 25,000, 50,000, 75,000 or 100,000? Theanswer when we return. Join the American Health Journal on Facebook. Search for American HealthJournal. How many high school football players sustain a concussion each year? The answeris over 100,000. The CDC also reports that 62% of these injuries occur during practice,not during games. Now with the latest information on cancer treatment here's our reporter LoraWindsor. According to the American Cancer Society, more than one and a half millionpeople in the United States are diagnosed with cancer each year. Lisa Wang a boardcertified hematologist and oncologist at PIH Health in Whittier, California discusses theadvancements in cancer treatments in the last

Category: Neuropathic Pain

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