Trophic Changes
Trophic Changes
1.Trophic Changes In The Skin & Appendages:
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Dry/ Rough/ Cold Skin
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Pigmentation
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Local Cyanosis/Local Oedema
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Hypohydrosis (Lack Of Sweating)
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Hypotrichosis(Fall Of Hairs)
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Brittle Nails
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2.Trophic Ulcers:
Trophic Ulcer- Usually Present Over The Heel Or Ball Of The Great Toe
Sites Examined-
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On The Lateral Malleolus
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Back Of The Heel Of Foot
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Shoulder Girdles
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Over The Sacrum (Classical Bed Sore)
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3.Charcot Joint / Neuropathic Joint:
This Is A Chronic, Progressive Degenerative Arthropathy.
Characterised By–
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Huge Swelling Of Knee (Most Common Site), Hip, Ankle Or Shoulder Joints.
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Painless( Most Characteristic)
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Disorganised, Deformed And Destroyed Joint.
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Increased Mobility Of Joint And Thus Easy Dislocation Is Possible
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Loose Bodies May Be Palpated In The Joint Cavity And Crepitus May Be Felt
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Causes Of Trophic Ulcer In Feet/ Charcot Joint-
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Leprosy
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Diabetes Mellitus
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Syringomyelia
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Tabes Dorsalis
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Sometimes After Repeated Intra-Articular Injection Of Steroid
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Charcot Joint Is The Complication Of Chronic Loss Of Proprioception.
Pathophysiology Of Development Of Charcot Joint-
Loss Of Proprioception → Recurrent Trauma → Damage Got Unnoticed By The Neuropathic Patient → Progressive Destruction, Degeneration And Disorganisation Of The Joint.
Radiological Features Of Charcot Joint-
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Osteopenia
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Sharp Cortical Margin
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Severe Disruption & Disorganisation Of The Joint
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Inappropriate New Bone Formation
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Management Of Charcot Joint-
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Treatment Of Underlying Disorder
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Stabilisation Of The Joint Is Done By Braces & Splints.
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In Case Of Diabetes Mellitus, Prevent Weight Bearing In The Foot For 2 Months To Prevent Severe Diseases (Trophic Ulcer).
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Lastly Fusion Of A Very Unstable Joint May Be Done
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