Osteopenia, neurological dysfunction, and the development of charcot neuroarthropathy

Abstract

OBJECTIVE - To determine factors that might be associated with the development of Charcot neuroarthropathy. RESEARCH DESIGN AND METHODS - This cross-sectional prevalence study examined neurological function and bone density in matched groups of neuropathic diabetic patients with and without radiological evidence of Charcot neuroarthropathy. RESULTS - Patients with Charcot neuroarthropathy had a global impairment of neurological function that was significantly greater than that of otherwise matched non Charcot neuropathic patients. All 17 Charcot patients had evidence of autonomic neuropathy compared with 10 of the control subjects (P = 0.03). The Charcot patients had evidence of reduced bone density in the lower limbs compared with the neuropathic control subjects (P = 0.009), but relatively preserved bone density in the spine (P = 0.4 vs. control subjects). CONCLUSIONS - We conclude that minor trauma in diabetic patients with peripheral neuropathy might result in a fracture in those with a reduced bone density and thus trigger the development of Charcot neuroarthropathy.