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August 1987

Neuro-osteoarthropathy (Charcot's Joint) in Diabetes Mellitus Following Revascularization Surgery: Three Case Reports and a Review of the Literature

Author Affiliations

From the Department of Medicine, New England Deaconess Hospital and Joslin Diabetes Clinic, Boston. Dr Edelman is now with the Department of Endocrinology and Metabolism, Veterans Administration Hospital, La Jolla, Calif. Dr Kosofsky is now with the Department of Podiatric Medicine, Brockton-West Roxbury (Mass) Veterans Administration Medical Center. Dr Paul is now in private practice in Madison, NJ.

Arch Intern Med. 1987;147(8):1504-1508. doi:10.1001/archinte.1987.00370080142027

• The initial primary defect in the development of neuro-osteoarthropathy is neuropathy. Our case reports and a review of the literature strongly implicate a neurally initiated vascular reflex leading to increased blood flow. This may play a pivotal role in the development of Charcot's joint in the neuropathic limb. Mechanical trauma in an insensitive foot is contributory, but it is probably a secondary mechanism.

(Arch Intern Med 1987;147:1504-1508)