Objectives

Our aim was to characterize the ultrasonographic features of patients with acute Charcot neuroarthropathy (CN) of the foot.

Methods

In this prospective study, 26 patients with CN of the foot proved by MRI were enrolled. All patients were in early stage of CN with normal radiography (grade 0 modified Eichenholtz classification system). Ultrasonographic examination of mid-tarsal and ankle joints was performed with a 7–15 MHz linear probe.

Results

Ages of our patients ranged from 38 to 67 years (57.3 ± 6.4). About 96.2% of our patients (25 patients) had diabetes mellitus. Ultrasonographic findings were as follows: effusion/synovitis (100%) with high Doppler activity (92.3%) in the mid-tarsal joints, and effusion/synovitis (92.3%) and high Doppler activity (84.6%) in the ankle joints. Bone erosions were present in the distal fibula in 23 patients (79.3%), while in distal tibia in 9 patients (34.6%). Tendonitis was found in tibialis posterior tendons in 23 patients (88.4%), and in peroneal tendons in 22 patients (84.6%). A combination of active synovitis (in mid-tarsal joints and ankle joints), active tendonitis (of tibialis posterior and peroneal tendons), and erosions in the distal end of fibula was present in 21 patients (80.8%).

Conclusions

Ultrasonography is able to detect soft tissue inflammation and pre-radiographic bony changes in early stages of CN.

Key Points •Ultrasound is a useful diagnostic tool for pre-radiographic stages of Charcot joint. •High-grade synovitis, high-grade tenosynovitis, and bony erosions are highly suggestive of Charcot arthropathy.

中文翻译：

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足部急性Charcot神经性关节炎的超声检查特征：一项初步研究。

目标

我们的目的是表征患有足部急性Charcot神经关节炎（CN）的患者的超声特征。

方法

在这项前瞻性研究中，纳入了26例经MRI证实为足部CN的患者。所有患者均处于CN早期，放射学检查正常（0级改良Eichenholtz分类系统）。用7–15 MHz线性探头对was骨和踝关节进行超声检查。

结果

我们患者的年龄为38至67岁（57.3±6.4）。我们的患者（25名患者）中约96.2％患有糖尿病。超声检查结果如下：-骨中部关节积液/滑膜炎（100％），多普勒活动高（92.3％）；踝关节积液/滑膜炎（92.3％），多普勒活动高（84.6％）。骨侵蚀存在于远端腓骨中的23名患者（79.3％），而胫骨远端存在9名患者（34.6％）。在23例胫骨后肌腱中发现肌腱炎（88.4％），在22例患者腓骨肌腱中发现肌腱炎（84.6％）。活动性滑膜炎（在mid中部和踝关节处），活动性肌腱炎（胫骨后和腓骨肌腱）和腓骨远端糜烂的组合存在于21例患者中（80.8％）。

结论

超声检查能够检测出CN早期的软组织炎症和X线检查前的骨变化。

关键点 •超声检查是夏科特关节放射前检查阶段的有用诊断工具。 •高度滑膜炎，高度腱鞘炎和骨侵蚀强烈提示炭疽病。