Muscle atrophy and muscle edema significantly more severe in diabetic patients with Charcot foot disease

Key findings of the study were:

• Interreader correlation for fatty infltration was substantial to almost perfect (kappa-values:0.73–1.0).

• Frequency of fatty muscle infltration was high in both groups (CF:97.1–100%; control:77.1–91.4%), but severe infiltration was significantly more frequent in CF patients (p-values: < 0.001–0.043).

• Muscle edema was also frequently seen in both groups, but significantly more often in the CF group (p-values: < 0.001–0.003).

• CSAs of hindfoot muscles were significantly smaller in the CF group. For the flexor digitorum brevis muscle, a cutoff value of 139 mm2 (sensitivity:62.9%; specifcity:82.9%) in the hindfoot was found to differentiate between CF disease and the control group.

• No correlation was seen between fatty muscle infiltration and the Balgrist Score.

The authors concluded - “Muscle atrophy and muscle edema are significantly more severe in diabetic patients with CF disease. Muscle atrophy does not correlate with the severity of active CF disease. A CSA < 139 mm2 of the flexor digitorum brevis muscle in the hindfoot may indicate CF disease.” 

For details of steps please refer to:

Muscle atrophy in diabetic patients with Charcot foot: a case control study

Martin C. Berli, Nicolas Azaiez et al

Skeletal Radiology (2023) 52:1661–1668

https://doi.org/10.1007/s00256-023-04328-1