Embaby Osama, Bin Asmadi Afdhal, Binte Asmadi Aiman, Haroun Ahmed, Mersal Mahmoud, Elalfy Mohamed
Trauma and Orthopedics Sandwell & West Birmingham Hospitals NHS Trust.
Mansoura University.
Orthop Rev (Pavia). 2025 Sep 15;17:144007. doi: 10.52965/001c.144007. eCollection 2025.
Acute Diabetic Charcot Arthropathy (ADCA) is a severe complication of diabetes mellitus in patients with peripheral neuropathy, often misdiagnosed due to its similarity to cellulitis or deep vein thrombosis. This review examines ADCA's pathophysiology, emphasizing early diagnosis to prevent progression. We explore the roles of inflammatory cytokines (TNF-α, IL-1β, IL-6) in bone loss and joint degeneration, and investigate potential biomarkers and therapeutic targets in Wnt and IL-17 signaling pathways. The impact of metabolic imbalances and comorbidities on ADCA development is also discussed. Our analysis reveals ADCA's complex, multifactorial nature, involving neuropathy, inflammatory responses, and metabolic dysregulation. A comprehensive management approach aimed at achieving a stable, ulcer-free foot is essential to improve patient mobility and quality of life. We conclude that early intervention is crucial, focusing on reducing stress on affected regions in inflammatory stages. This is achieved by highlighting and implementing the advances in clinical practice, integration of recent research, education of patients on the importance of early intervention alongside developing improvements to current treatments.
急性糖尿病性夏科氏关节病(ADCA)是糖尿病患者外周神经病变的一种严重并发症,因其与蜂窝织炎或深静脉血栓形成相似,常被误诊。本综述探讨了ADCA的病理生理学,强调早期诊断以防止病情进展。我们探究了炎性细胞因子(TNF-α、IL-1β、IL-6)在骨质流失和关节退变中的作用,并研究了Wnt和IL-17信号通路中的潜在生物标志物和治疗靶点。还讨论了代谢失衡和合并症对ADCA发生发展的影响。我们的分析揭示了ADCA具有复杂的多因素性质,涉及神经病变、炎症反应和代谢失调。旨在实现足部稳定、无溃疡的综合管理方法对于改善患者的活动能力和生活质量至关重要。我们得出结论,早期干预至关重要,重点是在炎症阶段减轻患部压力。这可通过突出并实施临床实践中的进展、整合近期研究成果、向患者宣传早期干预的重要性以及改进当前治疗方法来实现。