Controversies in the management of active Charcot neuroarthropathy

Gooday, Catherine, Hardeman, Wendy ORCID:, Poland, Fiona ORCID:, Woodburn, Jim and Dhatariya, Ketan (2023) Controversies in the management of active Charcot neuroarthropathy. Therapeutic Advances in Endocrinology and Metabolism, 14. ISSN 2042-0196

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Charcot neuroarthropathy (CN) was first described over 150 years ago. Despite this there remains uncertanity around the factors that contribute to its development, and progression. This article will discuss the current controversies around the pathogenesis, epidemiology, diagnosis, assessment and management of the condition. The exact pathogenesis of CN is not fully understood, and it is likely to be multifactorial, with perhaps currently unknown mechanisms contributing to its development. Further studies are needed to examine opportunities to help screen for and diagnose CN. As a result of many of these factors, the true prevalence of CN is still largely unknown. Almost all of the recommendations for the assessment and treatment of CN are based on low-quality level III and IV evidence. Despite recommendations to offer people with CN nonremovable devices, currently only 40–50% people are treated with this type of device. Evidence is also lacking about the optimal duration of treatment; reported outcomes range from 3 months to more than a year. The reason for this variation is not entirely clear. A lack of standardised definitions for diagnosis, remission and relapse, heterogeneity of populations, different management approaches, monitoring techniques with unknown diagnostic precision and variation in follow-up times prevent meaningful comparison of outcome data. If people can be better supported to manage the emotional and physical consequences of CN, then this could improve people’s quality of life and well-being. Finally, we highlight the need for an internationally coordinated approach to research in CN.

Item Type: Article
Additional Information: Funding Information: The authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: C.G., Clinical Doctoral Research Fellow (ICA-CDRF-2015-01-050) was funded by Health Education England (HEE)/National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.
Uncontrolled Keywords: charcot neuroathropathy,controversies,diabetes,endocrinology, diabetes and metabolism ,/dk/atira/pure/subjectarea/asjc/2700/2712
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 07 Mar 2023 10:31
Last Modified: 15 May 2023 16:30
DOI: 10.1177/20420188231160406

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