Treatment of neuroarthropathy, neuroarthropathy

1.Conservative ** is mainly to strengthen joint protection, such as local brake bracket protection. 2.

Symptomatic** anti-inflammatory and analgesic drugs can be used when the pain is severe, but such drugs should be used in small amounts for a long time to avoid accelerating joint destruction. Intra-articular injection of hormone drugs is not recommended for multiple uses, as these drugs have a more obvious effect on reducing inflammation and relieving symptoms, so that patients increase joint activity and accelerate the wear and tear of joints. 3.

First pinpoint and then target. 4.There is no specific approach to arthropathy, and the prognosis varies with the severity of the disease and response to surgery.

**The principle is to reduce weight bearing, protect and stabilize the joints. Standard** strategies include elevation of the affected limb and immobilization of the joint, reduction of throwing and waving for upper limb joint involvement, minimising standing time and walking distance for lower limb involvement, and walking crutches to prevent joint sprains. Unstable joints can be protected with braces, and orthoses and joint protection devices are quite effective in foot involvement.

Diabetic neuropathy involving the foot and ankle joints uses a "restricted walker" to effectively control limb edema and prevent joint deformity. 5.At present, joint cleaning and arthrodesis are still the main surgery, and special attention should be paid to the placement of effective negative pressure suction after surgery, and attention should be paid to the late postoperative activity time to avoid participating in heavy physical labor.

Neuropathic arthropathy is considered a contraindication to joint replacement surgery due to loss of effective innervation, poor nutrition, poor bone structure, and easy implant loosening and failure. Surgery** such as arthrodesis or arthroplasty may reduce pain, knee arthrodesis may be used for knee lesions with intact proprioceptive pathways, and spinal fusion may be used for spinal involvement, which is also beneficial for foot and knee involvement, but must avoid nonunion and recurrence of fractures. Exostomyctomy partially restores motor function and reduces joint pain, especially in patients with unsteady standing or severe deformities.

Due to the extremely high failure rate of implant placement, total joint replacement has traditionally been considered too risky for patients with this disease, but with the improvement of technology, selective total joint replacement can be effective in some patients. Indications for surgery include refractory pain and mild neuropathy. Surgical outcomes can be improved by extensive bone implantation to correct severe bone loss and careful ligament repair.

Rarely, amputation may be considered in severe cases of infection, progressive ulcers, or joint destruction.

Hello. Generally, there is some pain, obvious exudation (often hemorrhagic), incomplete dislocation and instability. Neurogenic arthropathy progresses much more rapidly than osteoarthropathy. Early detection and early **, at the same time, the patient himself must also pay attention to the combination of work and rest, and the reasonable arrangement of diet.

There are three main examination methods for this disease: (1) X-ray examination usually divides the X-ray manifestations of this disease into three types, namely, absorption type, hyperplastic type, mixed type, early degenerative changes in the joints can be seen on X-ray, mild hardening, erosion and destruction of the articular surface, and the articular end sclerosis of the affected bone in the late stage of the lesion is more obvious, accompanied by bone hyperplasia, destruction, periosteal reaction, joint deformity, irregular articular surface, collapse, narrowing of the joint space, joint dislocation or subluxation, and swelling of the soft tissues around the joint, Irregular calcified plaques or bone fragments in soft tissues, severe joint destruction and mild pain in patients, and functional impairment are the clinical features of this disease, and X-rays can show basic features, but X-rays cannot determine the specific extent and amount of fluid in the joint cavity, and cannot distinguish between the increased density of soft tissues caused by joint effusion and soft tissue swelling, and sometimes it is impossible to distinguish whether the free bone fragment is in the joint cavity or in the periarticular soft tissue.

2) CT examination due to the advantages of CT with high resolution, can better show the structure of the lesion, bone destruction and adjacent soft tissues, can distinguish whether the loose body shown by X-ray is located in the joint cavity or soft tissue, although plain film is the first choice and basic method for diagnosing this disease, but due to the wide application and high resolution of CT, the combination of CT and X-ray can more clearly show the lesion, which is helpful to determine the specific scope and amount of fluid in the joint cavity. Distinguishing between joint effusion and increased soft tissue density caused by soft tissue swelling, and distinguishing whether free bone is in the joint cavity or periarticular soft tissue, CT can be used as an important examination tool in cases where plain radiographs cannot be diagnosed or the extent of the lesion is difficult to determine.

Recommendation: Neuroarthritis is characterized by a full, swollen joint with bleeding and oozing. In the early stage of this disease, there is no pain, which is not easy to be taken seriously by patients, and only manifests as joint swelling, weakness, overactivity, and shaking.

Joint swelling, **, and abnormal range of motion are important features of the disease. X-rays can show extensive destruction, hardening or strange morphology of the joints, osteophyte formation, irregular or widened joint space, calcification of surrounding soft tissues, intra-articular loose bodies, bone fragments, etc. Combined with X-rays and clinical symptoms, the diagnosis can be confirmed if the patient has a primary neurological disease.

The first of these diseases should be active in the primary neurological disease. In the acute phase of the disease, rest should be avoided, joint trauma should be avoided, and a brace should be used as soon as possible to stabilize and protect the joint to prevent the development of deformity and bone end destruction. Excessive standing, walking, jumping, and weight-bearing should be avoided.

Particular attention should be paid to the prevention and control of infection, which is difficult to control and many patients suffer from amputation. According to the condition, hot compresses, physiotherapy, traditional Chinese medicine fumigation, acupuncture and internal administration of traditional Chinese medicine can be used, which have certain curative effects.

Charcot first described neuropathic arthropathy in 1868, also known as Charcot arthropathy, or Charcot arthropathy. This kind of disease is caused by ** sense, and it is also known as ** sexual malpractice imitation joint disease. It is a destructive joint disease secondary to neurosensory and neurotrophic disorders, mostly in adults, and more common in the ages of 40 to 60 years.

Clusters can occur in any joint and spine, and tenocclusive fibers occur in joints, often with unilateral involvement. The site of onset is often closely related to the primary disease.

Neuroarthropathy joints become enlarged, unstable, and fluid accumulate, and blood-like fluid may be drawn from the joints. Swollen joints are mostly painless or mildly swollen, and joint function is not restricted. Joint pain and functional limitations are inconsistent with joint swelling and destruction.

Late joint destruction progresses, which can lead to pathologic fractures or pathologic joint dislocations.

X-ray examinations usually divide the x-ray findings of the disease into three types: absorption, proliferative, and mixed. Early degenerative changes in the joints can be seen on x-ray, with mild hardening, invasion, and destruction of the articular surface. The articular end sclerosis of the affected bone is more obvious in the late stage of the lesion, with bone hyperplasia, destruction, periosteal reaction, joint deformity, irregular and collapsed articular surface, narrowing of the joint space, and joint dislocation or subluxation.

Swelling of the soft tissues around the joints, irregular calcified plaques or bone fragments within the soft tissues. Severe joint destruction is very inconsistent with the patient's mild pain and dysfunction is a clinical feature of this disease. X-rays may show features of the basic segmentation of neuroarthropathy, but x-rays cannot determine the exact extent and volume of the fluid in the joint cavity, distinguish between the joint effusion and the increased soft tissue density caused by soft tissue swelling, and sometimes distinguish whether the free bone is in the joint cavity or in the periarticular soft tissue.

Due to the advantages of high resolution, CT can better show the structure of the lesion, bone destruction and adjacent soft tissues. It can distinguish whether the loose body on x-ray is located in the joint cavity or in the soft tissue. In cases where plain radiographs are not diagnostic or difficult to determine the extent of the lesion, CT can be used as an important examination.

MRI images of the musculoskeletal system have a good natural contrast, and MRI can clearly show the anatomical morphology and provide biochemical and pathological information. Bone tissue shows very low signal on MRI, but its morphology and structure can still be clearly displayed against the background of bone marrow tissue and extraosseous soft tissue. MRI is not sensitive to calcifications and ossifications of bone and soft tissues, and it is difficult to show small or thin calcifications and ossifications.

For the diagnosis of neuroarthropathy, MRI helps determine the extent and extent of the lesion and is a necessary complement to x-ray and CT.