transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2021-8-1-12-18transmed-600Research ArticleЭНДОКРИНОЛОГИЧЕСКИЕ ЗАБОЛЕВАНИЯMETABOLIC DISEASESЛучевая диагностика диабетической нейроостеоартропатии ШаркоRadiology diagnostics of the diabetic Charcot neuroarthropathyhttps://orcid.org/0000-0002-5285-8303БреговскийВ. Б.BregovskiyV. B.

Бреговский Вадим Борисович - доктор медицинских наук, врач кабинета «Диабетическая стопа» ГКДЦ № 1.

ул. Сикейроса, д. 10Д, Санкт-Петербург, 194354.

eLibrary SPIN: 2547-3330

Bregovskiy Vadim B. - MD, Dr. Sci., Saint Petersburg City Consultative Diagnostic Centre.

Saint Petersburg.

dfoot.tdc@gmail.comГородской консультативно-диагностический центр № 1РоссияSaint Petersburg City Consultative Diagnostic CentreRussian Federation202130032021811218Copyright © Бреговский В.Б., 20212021Бреговский В.Б.Bregovskiy V.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/600

Под диабетической нейроостеоартропатией Шарко (ДНОАП) понимают асептическую воспалительную деструкцию суставов стопы или голеностопного сустава. Исходом ДНОАП являются деформации стопы различной степени тяжести, приводящие к снижению опороспособности конечности, а также к высокому риску образования трофической язвы стопы и ампутации. Сложности в диагностике данной патологии обусловлены особенностями ее клинической картины и отсутствием надежных методов диагностики. В настоящее время для визуализации артропатии Шарко применяются рентгенография, магнитно-резонансная томография, а также радиоизотопные методы исследования. Рентгенография, несмотря на высокую доступность и дешевизну, непригодна для диагностики ДНОАП на ранней стадии. Магнитно-резонансная томография отличается высокой диагностической значимостью на ранней стадии и дает ценную информацию об активности процесса на протяжении лечения, но дорога и ограниченно доступна. Радиоизотопные методики практически недоступны и используются в научных целях. При этом ни один из этих методов не является надежным для диагностики всех стадий ДНОАП, в особенности — перехода в неактивную стадию. Представленный обзор характеризует достоинства и недостатки этих видов диагностики.

Diabetic neuroosteoarthropathy (Charcot foot, DNOAP) is the aseptic inflammatory destruction of the joints of the foot or ankle. The outcome of DNOAP is foot deformities of various degrees of severity, which lead to a decrease in the ability to weight-bearing, as well as to a high risk of foot ulcer and amputation. Features of the clinical picture and the lack of reliable diagnostic methods lead to difficulties in the diagnosis of this pathology. Currently, radiography, magnetic resonance imaging, and radioisotope methods are used to visualize Charcot's arthropathy. Plain X-radiography, despite its high availability and low cost, is unsuitable for the diagnosis of DNOAP at an early stage. Magnetic resonance imaging is characterized by high diagnostic significance at an early stage and provides valuable information about the activity of the process during treatment, but it is expensive and limited. Radioisotope techniques are practically unavailable and are used for scientific purposes. At the same time, none of these methods is reliable for the diagnosis of all stages of DNOAP, especially the transition to the inactive stage. The present review characterizes the advantages and disadvantages of these types of diagnostics.

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The authors declare that there are no conflicts of interest present.