Cover Journal of the American Podiatric Medical Association
Journal of the American Podiatric Medical Association
ISSN:
8750-7315
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Article Type:
Original Articles
Online Publication Date:
30 Jul 2020

Characteristics of Patients with Charcot's Arthropathy and its Complications in the Saudi Diabetic Population: A Cross-Sectional Study

Khalid Al-Rubeaan
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 FRCPC
,
Khaled H. Aburisheh
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 MRCP
,
Yousuf Al Farsi
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 MD
,
Mohammad Al Derwish
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,
Samir Ouizi
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 Bsc, MPodMed
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Fahad Alblaihi
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 MBBS, ABFM
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Ali Jaber ALHagawy
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 MBBS, ABFM
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Rakan Khalid AlSalem
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Musab Abdualaziz Alageel
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Mona Heide Toledo
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Amira M. Youssef
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 BPharm
DOI:
https://doi.org/10.7547/18-197
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Background

Charcot's arthropathy (CA) is a destructive rare complication of diabetes, and its diagnosis remains challenging for foot specialists and surgeons. We aimed to assess the clinical presentation and characteristics of CA and the frequencies of its various types.

Methods

This cross-sectional study was conducted from January 1, 2007, to December 31, 2016, and included 149 adults with diabetes diagnosed as having CA. Cases of CA were classified based on the Brodsky anatomical classification into five types according to location and involved joints.

Results

The mean ± SD age of the studied cohort was 56.7 ± 11 years, with a mean ± SD diabetes duration of 21.2 ± 7.0 years. The CA cohort had poorly controlled diabetes and a high rate of neuropathy and retinopathy. The most frequent type of CA was type 4, with multiple regions involved at a rate of 56.4%, followed by type 1, with midfoot involvement at 34.5%. A total of 47.7% of the patients had bilateral CA. Complications affected 220 limbs, of which 67.7% had foot ulceration. With respect to foot deformity, hammertoe affected all of the patients; hallux valgus, 59.5%; and flatfoot, 21.8%.

Conclusions

There is a high rate of bilateral CA, mainly type 4, which could be attributed to cultural habits in Saudi Arabia, including footwear. This finding warrants increasing awareness of the importance of maintaining proper footwear to avoid such complications. Implementation of preventive measures for CA is urgently needed.

University Diabetes Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Diabetic Foot Unit, University Diabetes Center, King Saud University, Riyadh, Saudi Arabia.

College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Strategic Center for Diabetes Research, Riyadh, Saudi Arabia.

Corresponding author: Khalid Al-Rubeaan, FRCPC, King Saud University, PO Box 18397, Riyadh 11415, Saudi Arabia. (E-mail: rubeaan@gmail.com)
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