[Diabetes-talk] FW: [acb-diabetics] crippling condition often misdiagnosed

[Mike Freeman]

From: acb-diabetics-bounces at acb.org [mailto:acb-diabetics-bounces at acb.org]
On Behalf Of Patricia LaFrance-Wolf
Sent: Tuesday, September 06, 2011 6:29 PM
To: Acb-Diabetics at Acb. Org
Subject: [acb-diabetics] crippling condition often misdiagnosed

 

 


Crippling Condition Associated with Diabetes Often Misdiagnosed and
Misunderstood


1-Sep-2011

Robert Winkler says he limped around on his painful left foot for six
months, suffering unnecessarily from a misdiagnosis by a physician who
didn't know about the symptoms and treatments for Charcot foot, a form of
localized osteoporosis linked to diabetes that causes the bones to soften
and break, often resulting in amputation.

When his primary care physician finally agreed to Mr. Winkler's request for
an x-ray, they discovered the metatarsal bones in Mr. Winkler's left foot
were all broken-a common symptom of this serious and potentially
limb-threatening lower-extremity complication.

A new article in the September issue of the journal, Diabetes Care,
describes Charcot foot and its treatment with a goal of educating medical
professionals about this painful inflammation of the foot. The article is
the product of an international task force of experts convened by the
American Diabetes Association and the American Podiatric Medical Association
in January to summarize available evidence on the pathophysiology, natural
history, presentations and treatment recommendations for Charcot foot
syndrome.

"Even though it was first described in 1883, the diagnosis and successful
treatment of Charcot foot continue to be a challenge because this syndrome
is not widely known or understood by the broader medical profession," said
Lee C. Rogers, D.P.M., co-director of the Amputation Prevention Center at
Valley Presbyterian Hospital in Van Nuys, CA, and lead author of the
Diabetes Care article. "Charcot foot is now considered to be an inflammatory
syndrome most often seen in patients with diabetes which can be successfully
treated in its early stages."

The article describes Charcot foot as a condition affecting the bones,
joints and soft tissues of the foot and ankle, which is characterized by
inflammation in the earliest phase and is associated with diabetes and
neuropathy. The report finds offloading, or removing weight from the foot,
is the most important initial treatment recommendation. Surgery can be
helpful in early stages involving acute fractures of the foot or ankle or in
later stages when offloading is ineffective, according to the article.

In Mr. Winkler's case, he was first diagnosed with Charcot foot in 2004 and
had already undergone one surgery that relieved the problem for several
years. By 2010, though, he was facing the potential amputation of the foot
because of complications associated with Charcot foot syndrome.

His podiatrist referred him to Dr. Rogers at Valley Presbyterian Hospital's
Amputation Prevention Center, an integrated limb salvage center that is one
of only a handful in the nation. Since its December 2009 opening, the
Amputation Prevention Center's specialized multidisciplinary team of highly
skilled professionals has treated patients from all over the country and
around the world with leading-edge technology, achieving a limb salvage rate
of 96 percent.

George Andros, M.D., the Center's Medical Director, performed vascular
surgery to restore circulation to Mr. Winkler's left foot so that it would
heal. Then, Dr. Rogers performed surgery to rebuild the bones in Mr.
Winkler's foot. Dr. Rogers also implanted a bone stimulator that acts like a
pacemaker for bones which encourages Mr. Winkler's body to rebuild and fuse
the broken bones in his left foot. As a result, Mr. Winkler is expected to
be able to recover the use of his left foot.

"I'm very pleased because I had gone to another doctor and he wanted to
amputate my foot," Mr. Winkler said. "When I found Dr. Rogers and Valley
Presbyterian Hospital's Amputation Prevention Center, it's like I found a
blessing and an angel in disguise. I have tears running down my face as I
describe to you how I will be able to get up out of my chair and walk
because of the care I received at Valley Presbyterian Hospital. All the
people there are superb. They treat me like a king."

Source: Valley Presbyterian Hospital

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