It has been recognized since comprehensive descriptions by Jean-Martin Charcot in 1868 and 1883 that development of what is usually known as neuropathic osteoarthropathy (or the Charcot foot) requires the coincidence of neuropathy and inflammation. Despite this, detailed understanding of the causes has remained remarkably limited in the succeeding century and a half. The aim of this descriptive account is to draw particular attention to the processes involved in both the onset and resolution of the inflammation that is an essential component of active disease. The principal observation is that while neuropathy is common in people with diabetes, the inflammation and secondary skeletal damage that characterize neuropathic osteoarthropathy are observed in only a small minority of people with diabetes and with neuropathy. We therefore argue that the key to understanding the causes of the Charcot foot is to focus equally on those who have active disease as well as those who do not. Although neuropathy is essential for development of the disorder, neuropathy also has an adverse impact on the mechanisms involved in the onset of inflammation, and these may be critically affected in the majority of those who are susceptible. The Charcot foot is uncommon in people with diabetes (or any other cause of neuropathy) because the large majority of those with neuropathy may have also lost the capacity to mount the specific inflammatory reaction that is essential for its development.

中文翻译：

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夏科脚反映了对因先前存在的神经损伤而严重扭曲的损伤的反应：不完美的风暴

自 Jean-Martin Charcot 在 1868 年和 1883 年的全面描述以来，人们认识到通常所说的神经性骨关节病（或夏科足）的发展需要神经病变和炎症同时发生。尽管如此，在接下来的一个半世纪里，对其原因的详细了解仍然非常有限。该描述性说明的目的是引起人们对炎症发生和消退所涉及的过程的特别关注，炎症是活动性疾病的重要组成部分。主要观察结果是，虽然神经病变在糖尿病患者中很常见，但神经性骨关节病特征的炎症和继发性骨骼损伤仅在少数患有糖尿病和神经病变的患者中观察到。因此，我们认为，了解夏科足病因的关键是同等关注那些患有活动性疾病的人和那些没有活动性疾病的人。尽管神经病变对于该疾病的发展至关重要，但神经病变也会对炎症发生的机制产生不利影响，并且这些机制可能在大多数易感者中受到严重影响。夏科足在糖尿病（或任何其他原因引起的神经病变）患者中并不常见，因为大多数神经病变患者可能也失去了对其发展至关重要的特定炎症反应的能力。