title: [Visualization of local cortical defects in Charcot foot using microcomputed tomography].
abstract: BACKGROUND
  In the pathogenesis of diabetic neuropathic osteoarthropathy (Charcot's foot) fractures cause chronic destruction of soft tissue and bone structure. To improve an early diagnosis of Charcot foot, modern diagnostic imaging is mainly based on magnetic resonance imaging (MRI), for example in relation to the detection of cortical bone fractures.
  
  
  OBJECTIVE
  In this study we investigated the cortical microstructure in cases of Charcot foot with respect to fractures and porosity in order to visualize local cortical defects. This may substantiate recent efforts in a reclassification based on MRI.
  
  
  METHODS
  Using microcomputed tomography (microCT) we investigated bone parameters, such as cortical thickness and porosity in order to quantify the local metatarsal microstructure in cases of Charcot foot.
  
  
  RESULTS
  All bone samples showed a high degree of cortical porosity including pores that perforated the cortical bone. The data suggest that areas with reduced cortical thickness coincide with large cortical pores that may serve as initial points for fractures. Whether the detected microfractures are physiological or artefacts of preparation could not be determined.
  
  
  CONCLUSIONS
  By means of microCT we were able to visualize and quantify the extent of cortical porosity for the first time in high resolution. The data suggest that both cortical fractures and cortical porosity play an important role in the pathogenesis in cases of Charcot foot.
authors.affiliation: University of Applied Sciences Upper Austria, Stelzhamerstraße 23, 4600, Wels, Österreich, sascha.senck@fh-wels.at.
authors.forename: S
authors.initials: S
authors.lastname: Senck
authors.forename: B
authors.initials: B
authors.lastname: Plank
authors.forename: J
authors.initials: J
authors.lastname: Kastner
authors.forename: F
authors.initials: F
authors.lastname: Ramadani
authors.forename: K
authors.initials: K
authors.lastname: Trieb
authors.forename: S G
authors.initials: SG
authors.lastname: Hofstaetter
mesh_terms: D001177:Arthropathy, Neurogenic / Q000000981:diagnostic imaging*; D017719:Diabetic Foot / Q000000981:diagnostic imaging*; D005529:Foot Bones / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D011856:Radiographic Image Enhancement / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*