title: [Usefulness of Pamidronate in the Treatment of Charcot's Arthropathy].
abstract: OBJECTIVE
  To investigate the usefulness of pamidronate in the management of active Charcot's arthropathy.
  
  
  METHODS
  Open prospective study with a follow-up of 12 months, including patients with active neuroarthropathy seen over a period of 3 years in our rheumatology unit. Patients received three pamidronate infusions at 0, 2, and 4 months. Clinical assessment, serum and urine bone turnover markers, radiological exam, and scintigraphy were performed before and after treatment.
  
  
  RESULTS
  Seven patients were ncluded (4F/3M), mean age, 51.3 years (30-64). The underlying disease was diabetes mellitus in 4 cases, syringomyelia in 2, and sensory and autonomic neuropathy in 1. The joints affected were shoulder, ankle, tarsians, metacarpophalaneal, and metatarsophalangeal. All patients showed a rapid resolution of clinical symptoms, with a clear reduction of all bone remodeling markers that achieved statistical significance for urine NTX and urinary pyridoline (P=.04 and P=.03, respectively). Six of 7 patients disclosed at the end of follow-up a radiological healing. Quantitative scyntigraphy showed a clear reduction of the bone (99)Tm uptake. No important side affects were reported.
  
  
  CONCLUSIONS
  Pamidronate appears as a useful treatment for neuroarthropathy independently of the underlying disease. A rapid diagnosis and early pamidronate treatment could avoid severe articular consequences.
authors.affiliation: Unidad de Reumatología. Hospital de Sabadell. Institut Universitari Parc Taulí (UAB). Barcelona. España.
authors.forename: Mireia
authors.initials: M
authors.lastname: Moreno
authors.forename: Jordi
authors.initials: J
authors.lastname: Gratacós
authors.forename: Enrique
authors.initials: E
authors.lastname: Casado
authors.forename: Carlos
authors.initials: C
authors.lastname: Galisteo
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Orellana
authors.forename: Marta
authors.initials: M
authors.lastname: Larrosa