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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The typical location of diabetic osteoarthropathy is the foot. Involvement of other joints is rare. In the case treated by the author, the osteoarthropathy of the ankle and knee joints presented at the same time. The process healed in the ankle joint by grave deformity and arthrosis deformans resulted in the knee joint. If arthrosis appears in an unusual location, it is worth while to look for diabetes.
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PMID:[Diabetic osteoarthropathy of rare localization]. 1 81

Observations on the clinical effects of venesection therapy in 85 treated, as compared with 26 untreated, patients with idiopathic haemochromatosis showed decreased pigmentation and hepatomegaly together with a return to normal tests of liver function in half the patients who had abnormal tests at presentation. Control improved in 28 per cent of those patients with diabetes mellitus, although some patients developed it during the period of observation, despite venesection. Portal hypertension, testicular atrophy and arthropathy were not improved. In only 12 patients was there sufficient reaccumulation of iron after the initial course of venesection to merit further treatment. Rates of iron accumulation in these patients varied between 1-4 mg and 4-8 mg per day and chelatable iron levels were noted to be inappropriately high in relation to body iron stores during the early stages of the reaccumulation period. Life table data shows that the percentage survival five and ten years after diagnosis was 66 and 32 per cent respectively for the treated patients, and 18 and 6 per cent respectively for the untreated patients, both statistically highly significant differences (p less than 0-01). Possible clinical differences such as age of presentation, the presence of diabetes mellitus, cirrhosis, clinical hepatic failure and hepatoma between the treated and untreated groups that might otherwise have weighted survival in favour of the treated group were corrected by the use of covariant analysis. This gave mean log survival values of 4-15 and 2-88 for the treated and untreated patients respectively, equivalent to 63-4 months and 17-8 months, a highly significant difference (p less than 0-01). Ten patients, all of whom had cirrhosis at the time of diagnosis, died of malignant hepatoma between three and 15 years after completing venesection therapy. There was also a high rate of death from neoplasms in a variety of other sites--22 per cent in the venesected group, strikingly higher than that rate predicted for a similarly aged population using national cancer mortality rates.
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PMID:Long term results of venesection therapy in idiopathic haemochromatosis. 18 63

The osteopathy of the foot is a rare complication of diabetes mellitus. It is seen in the distal parts mostly. The arthropathy ("Charcot-joint") is even more rare, and is regularly combined with a neuropathy. The roentgen signs of the "diabetic foot" are demonstrated, as there are osteoporosis, iuxta-articular cortical defects, osteolysis of the bone ends, bone destruction and reconstruction, periost reaction and sklerosis of the bone shafts.
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PMID:[Exceptional diabetic arthropathy of the foot (author's transl)]. 43 86

Diabetic lesions in 25 patients with maturity-onset non-insulin-dependent diabetes, but with neuropathy and even other complications in spite of previous treatment, were studied. Distribution according to the duration of the diabetes and the age of the patients was comparable to that seen in insulin-dependent diabetes. The most frequent lesions are osteoporosis of the metaphysial line, interphalangeal arthrosis, and hallux valgus. A total of 7 perforating plantar ulcers were noted, and the physiopathology was similar to that described in insulin-dependent diabetes. Lowered insulin levels and the neuropathy which this produres are the major etiological factors, but foot deformities such as talipes equinus and/or flat-feet play a determining role. Treatment consists of insulin administration and avoidance of plantar pressure at the site of the lesions.
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PMID:[Foot lesions in non-insulin-dependent diabetes. A report on 25 cases (author's transl)]. 47 8

Neuropathic arthropathy (Charcot's joint) is a relatively painless, progressive and degenerative condition due to underlying neurologic deficits. Although a variety of neurologic disorders may produce this arthropathy, diabetes mellitus has become the most common cause. In diabetes, the foot and ankle are the sites most often involved, particularly the tarsometatarsal and tarsal joints. In addition to neuropathy, trauma is an essential factor in producing the arthropathy.
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PMID:Neuropathic arthropathy in the diabetic foot. 65 62

Osteo-articular changes observed in diabetic patients include diabetic osteo-arthropathy, infective osteo-arthritis, and osteo-arthrosis. A systematic review of 1,501 case-sheets demonstrated one or more bone lesions in 55% of the diabetic patients studied. There was a striking absence of the most typical lesions of the foot, probably party due to the fact that there has been an improvement in the treatment of diabetes. Osteolytic and reconstructive lesions were more common in women.
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PMID:[Osteo-articular lesions of the foot in diabetic patients. A systematic review of 1,501 radiological reports (author's transl)]. 74 70

Arthropathy is increasingly reported in diabetes. In a personal series of 300 subjects with undoubted diabetes mellitus (mean age: 67 yr), five cases of arthropathy (1.6%) were noted. The pathogenesis of this association is discussed, particularly in the light of the concomitance of neuropathy in 4-5 cases. The main clinical signs included: swelling, redness, mal perforans, and pied cubique diabetique. The incubation period of arthropathic lesions is also examined. The medical and surgical treatment of diabetic arthropathy is described.
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PMID:[Bone lesions of the foot in diabetic disease]. 90 39

Neurological affections responsible for secondary arthropathic pathology are: tabes, syringomyelia, diabetes mellitus, congenital insensitivity to pain syndrome, alcoholism, leprosy. Each of the affections shows predilection for specific joints: syringomyelia the shoulder, tabes the hip and knee, diabetes mellitus the foot, congenital insensitivity to pain the lower limb, alcoholism the shoulder and knee. The authors discuss two cases of hip arthropathy in previous dorsal myelic fractures.
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PMID:Neurogenic arthropathy. Differential diagnosis. 129 65

Radiologically visible lesions in the feet of patients with long-standing diabetes mellitus are common and varied. They include osteoporosis, osteosclerosis, osteolysis, juxta-articular defects of the cortical bone, ischemic bone necrosis, new bone formation, spontaneous fracture and subluxation, and neuropathic arthropathy. These manifestations result from diabetic angiopathy and neuropathy and usually are complicated by infection. In this review the author describes these protean radiologic features in light of their pathogenesis and discusses the diagnostic problems encountered.
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PMID:The radiologic spectrum of abnormalities of the foot in diabetic patients. 139 98

The 1991 literature on septic arthritis included a concise review of adult septic arthritis, examples of pseudoseptic arthritis, and two interesting animal studies. One animal study examined the induction of acute synovitis by the intra-articular injection of bacterial endotoxin and the cytokines tumor necrosis factor-alpha, and interleukin-1 beta; and the other studied the effects of early and delayed synovectomy in the management of septic arthritis. The predispositions to septic arthritis can be divided into local joint abnormalities, systemic factors, or both. Examples of the local joint abnormalities include osteoarthritis of the hip and apatite-associated arthropathy. Septic arthritis in a patient with rheumatoid arthritis, in a patient with diabetes mellitus and hip arthropathy associated with hemochromatosis, or in a patient with acquired immunodeficiency syndrome and hemophilic arthropathy are examples of how systemic predisposition is coupled with local joint pathology to increase the vulnerability of the host to joint infection. Other examples of systemic disease that predispose to septic arthritis are systemic lupus erythematosus, hypogammaglobulinemia, and human immunodeficiency virus infection, as well as intravenous drug abuse. Unusual microorganisms causing septic arthritis in the adult include Achromobacter xylosoxidans, Moraxella catarrhalis, meningococci, and diphtheroids. Uncommon pathogenesis is represented by a case of intra-articular inoculation of Mycobacterium gastri into the small joint of the hand and a case of mixed bacterial infection of the hip resulting from an extension of a contiguous pelvic infection associated with trauma. Two cases of immune complex glomerulonephritis illustrate the extra-articular complications of septic arthritis: one due to group G streptococcus and the other due to pneumococcus. Finally, septic bursitis is reviewed from the community practice perspective.
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PMID:Bacterial arthritis. 150 74


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