Ferreira Ricardo Cardenuto
Grupo de Cirurgia do Pé e Tornozelo, Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2020 Aug;55(4):397-403. doi: 10.1055/s-0039-3402460. Epub 2020 Apr 27.
Charcot neuroarthropathy (CN) is an unfortunate and common complication of patients with diabetes, most likely resulting from a lack of proper understanding of the disease, which leads to late diagnosis. It is commonly misdiagnosed as infection and treated with antibiotics and a frustrated attempt of surgical drainage, which will reveal only debris of the osteoarticular destruction. Proper education of diabetic patients and of the health care professionals involved in their treatment is essential for the recognition of the initial signs of CN. The general orthopedic surgeon is usually the first to treat these patients in the early stages of the disease and must be aware of the signs of CN in order to establish an accurate diagnosis and ensure proper treatment. In theory, this would make it possible to decrease the morbidity of this condition, as long as proper treatment is instituted early.
夏科氏神经关节病(CN)是糖尿病患者一种不幸且常见的并发症,很可能是由于对该疾病缺乏正确认识,导致诊断延迟。它常被误诊为感染,并使用抗生素治疗,还会尝试进行手术引流,但往往只能发现骨关节破坏的残骸。对糖尿病患者以及参与其治疗的医护人员进行适当教育,对于识别CN的早期症状至关重要。普通骨科医生通常是在疾病早期治疗这些患者的第一人,必须了解CN的症状,以便做出准确诊断并确保进行适当治疗。从理论上讲,只要尽早进行适当治疗,就有可能降低这种疾病的发病率。