[Diabetic neuroarthropathy in acute phase: a diagnostic dilemma. Two cases and bibliographic review].
BACKGROUND
Charcot's neuroarthropathy is a progressive deterioration of bones and joints, mainly the ankle and foot of the diabetic patients suffering severe neuropathy. Its pathogeny is not well known, although mechanical, vascular and neurological factors are thought to be involved, generally with a precipitating minor traumatic even. Charcot's foot acute phase is inflammatory, and it is often confused with other diseases such as arthritis, cellulitis and deep venous thrombosis (DVT). This leads to delays or errors in the diagnosis, the patient coming to the hospital too late with severe foot deformation.


OBJECTIVE
Thus, it must always be posed as differential diagnosis in a diabetic patient who comes with a warm and inflamed foot, generally without fever, even more if he has a severe autonomic or somatic neuropathy. In the acute onset, the only treatment has been complete and long term off-loading with a total contact cast that should be initiated immediately after diagnosis. More recent studies show promising results with biphosphonates to decrease bone turnover in acute phase.


CONCLUSIONS
We present two cases of acute Charcot's foot and we briefly review the bibliography.
Vázquez Gutiérrez
M
M
Servicio de Endocrinología, Hospital Universitario Virgen del Rocío, Sevilla.
Mangas Cruz
M A
MA
Cañas García-Otero
E
E
Astorga Jiménez
R
R
D000328:Adult; D000368:Aged; D001177:Arthropathy, Neurogenic / Q000150:complications / Q000175:diagnosis*; D003929:Diabetic Neuropathies / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male