Griffith J, Davies A M, Close C F, Nattrass M
Department of Radiology, General Hospital, Birmingham, UK.
Br J Radiol. 1995 Jan;68(805):27-33. doi: 10.1259/0007-1285-68-805-27.
Accurate radiographic evaluation of diabetic neuroarthropathy is increasingly difficult as the disease becomes more florid. 22 patients with a known diabetic neuroarthropathy of one or both feet were prospectively examined by computed tomography (CT) in the axial and coronal planes. Bilateral changes of a neuroarthropathy were present in 75% of cases. Distinct patterns of disease were seen and categorized into five types in order of increasing severity. Changes at the medial tarsometatarsal joints and adjacent intercuneiform joints were seen in all affected feet. More extensive disease involved the medial arch more commonly than the lateral. Fractures of the tarsal bones were found in 32% of cases and were associated with neuroarthropathic changes in adjacent joints. Calcaneal fractures were seen in four feet. A Lisfranc fracture-dislocation was present in 41% of cases and a bilateral in only 21%. A single CT examination of the foot, while an accurate method of demonstrating the extent of the disease, is an insensitive indicator of disease activity.
随着糖尿病性神经关节病病情愈发严重，对其进行准确的影像学评估变得越来越困难。对22例已知患有单足或双足糖尿病性神经关节病的患者进行了轴向和冠状面计算机断层扫描（CT）的前瞻性检查。75%的病例存在双侧神经关节病改变。观察到不同的疾病模式，并按严重程度递增顺序分为五种类型。所有受累足部均可见内侧跗跖关节和相邻楔骨间关节的改变。病变范围更广时，累及内侧足弓比外侧更常见。32%的病例发现跗骨骨折，且与相邻关节的神经关节病改变有关。在四只足部发现了跟骨骨折。41%的病例存在Lisfranc骨折脱位，仅21%为双侧。足部的单次CT检查虽然是显示疾病范围的准确方法，但却是疾病活动的不敏感指标。
