From South Orange, New Jersey, USA:
My aunt who is 54 years old has had diabetes since she was 21. She was just told that she has Charcot disease in her right ankle. What should be done to combat this disease?
Charcot was a 19th century French physician who became famous for his teaching in neurology at the Salpetriere Hospital in Paris. His name became attached to a condition in which there was massive, but largely painless, destruction of the knee or ankle joint associated with spinal cord damage to the fibers carrying pain.
Nowadays the condition can be recognised long before it reaches the stage of a severe arthropathy [joint damage]. The commonest cause is diabetic damage to peripheral nerves; but joint damage can occur in any joint and as a result of a wide variety of congenital and acquired disorders that diminish pain sensation. It can also be the result of rheumatoid arthritis, of gout and of infection, and the earliest stage may be mimicked by the rupture of a synovial cyst.
Treatment is for pain if it is needed; but for the most part is concerned with avoiding weight-bearing until healing has taken place and if necessary with immobilising the ankle joint either internally or externally.
Original posting 20 Nov 96
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