Publication: Microscopic study of chronic Charcot arthropathy foot bones contributes to understanding pathogenesis - a preliminary report.
Authors
Dharmadas, Salini ; Kumar, Harish ; Pillay, Minnie ; Jojo, Annie ; Tessy, P.J. ; Mangalanandan, Thacho Sukumaran ; Vivek, Lakshmanan ; Praveen, Valiyaparambil Pavithran ; Bal, Arun
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Publisher
Universidad de Murcia, Departamento de Biologia Celular e Histiologia
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DOI
https://doi.org/10.14670/HH-18-162
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info:eu-repo/semantics/article
Description
Abstract
Introduction. Charcot arthropathy (CA) is
non-infective, chronic destructive condition affecting the
pes architecture of long standing diabetic patients with
neuropathy. Even though several theories have emerged
to disclose its pathogenesis, inflammatory cytokine
induced osteoclastogenesis stands as the chief culprit.
Studies on micro-architecture of foot bones of acute
stage CA patients, describes mainly destructive phase of
bone remodelling. Increased osteoclast cell activity is
reported in all studies communicated. No study has to
the best of our knowledge detailed the microscopic
structure of chronic stage CA foot bones.
Aim. To study the microscopic structure of foot
bones in patients with chronic CA.
Materials and methods. Foot bones were collected
from the feet of chronic CA patients (six in number) who
underwent corrective foot surgery in the department of
Podiatric Surgery of a tertiary care hospital. Control
samples were collected from the feet of age matched
non-diabetic controls (2 in number). The samples were
fixed in formalin, decalcified in 10% nitric acid,
processed, sectioned and stained with haematoxylin and
eosin. Histopathology and histomorphometry analysis
were performed by two different pathologists.
Results. Trabeculae of chronic CA foot bones
exhibited mainly a lamellar architecture, with reduced
number of osteocytes and plenty of empty lacunae.
Trabecular connectivity was lost and trabeculae showed
considerable thinning. Trabecular osteoids lined by
active osteoblast cells was a remarkable observation.
Bone area was also considerably reduced in chronic CA
foot bones.
Conclusion. Chronic stage CA foot bones presented
features of both healing and fragile bone. The
compromised bone quality may be due to thin and
fragmented trabecular structure and reduced cellularity.
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