Boston Medical Center, Boston, MA; Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
Wounds. 2023 Jun;35(6):E203-E208. doi: 10.25270/wnds/22063.
Patients with diabetes and peripheral neuropathy have a 25% risk of developing a foot ulcer, and these can lead to soft tissue infections that worsen and result in osteomyelitis. While Charcot neuroarthropathy is not as common as osteomyelitis, it is often misdiagnosed as osteomyelitis.
Three patients presented with diabetes, neuropathy, and foot ulcers. They underwent prophylactic surgery but later developed swelling at the surgical sites. Radiographs showed fragmentations that caused concern about osteomyelitis. The authors maintained diagnoses of Charcot neuroarthropathy and treated the patients with immobilization and offloading. All patients resolved the fragmentations without antibiotics or surgery.
While Charcot neuroarthropathy and osteomyelitis have similar signs and symptoms, understanding the similarities and differences between the conditions can aid providers in appropriate wound management.
患有糖尿病和周围神经病变的患者有 25%的风险会发展为足部溃疡，这些溃疡可能导致软组织感染恶化并导致骨髓炎。虽然夏科氏关节病不像骨髓炎那么常见，但它经常被误诊为骨髓炎。
三名患者患有糖尿病、周围神经病变和足部溃疡。他们接受了预防性手术，但后来在手术部位出现肿胀。X 光片显示有骨碎片，这引起了对骨髓炎的担忧。作者维持夏科氏关节病的诊断，并通过固定和减压来治疗患者。所有患者在没有使用抗生素或手术的情况下解决了骨碎片问题。
虽然夏科氏关节病和骨髓炎有相似的体征和症状，但了解两种疾病之间的相似点和不同点可以帮助医务人员进行适当的伤口管理。
