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Re: Следует ли оперировать?
послал Adonin 05 Апрель 2010, 17:38
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http://emedicine.medscape.com/article/1234293-overview
In 1703, William Musgrave first described a neuropathic joint as an arthralgia caused by venereal disease.1 In 1868, Jean-Martin Charcot gave the first detailed description of the neuropathic aspect of this disease; hence, the condition is named after him.2 Charcot noted this disease process as a complication of syphilis
Pathophysiology
The exact nature of Charcot arthropathy remains unknown, but the following major theories exist regarding the pathophysiology of this condition:
Neurotraumatic theory - This theory states that Charcot arthropathy is caused by an unperceived trauma or injury to an insensate foot. The sensory neuropathy renders the patient unaware of the osseous destruction that occurs with ambulation. This microtrauma leads to progressive destruction and damage to bone and joints.
Neurovascular theory - This theory suggests that the underlying condition leads to the development of autonomic neuropathy, causing the extremity to receive an increased blood flow. This in turn results in a mismatch in bone destruction and synthesis, leading to osteopenia.
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