BACKGROUND AND PURPOSE: Diabetes mellitus (DM)-related neuropathic arthropathy of the foot is a destructive bone and joint process. The effect of cast immobilization and non-weight bearing on bone loss has not been well studied. The purpose of this case report is to describe the changes in bone mineral density (BMD) of the calcaneus in the feet of a patient with acute neuropathic arthropathy during total contact cast immobilization. CASE DESCRIPTION: The patient was a 34-year-old woman with type 1 DM, renal failure requiring dialysis, and a 7-week duration of neuropathic arthropathy of the midfoot. Intervention included total contact casting and minimal to no weight bearing for 10 weeks, with transition to therapeutic footwear. Ultrasound-derived estimates of BMD were taken of both involved and uninvolved calcanei. OUTCOME: Bone mineral density decreased for the involved foot (from 0.25 g/cm(2) to 0.20 g/cm(2)) and increased for the uninvolved foot (from 0.27 g/cm(2) to 0.31 g/cm(2)) during casting. DISCUSSION: The low initial BMD and further loss during casting suggest the need for transitional bracing and a well-monitored return to full activity to minimize the risk of recurrence and progression of foot deformity.
BACKGROUND AND PURPOSE:Diabetes mellitus (DM)-related neuropathic arthropathy of the foot is a destructive bone and joint process. The effect of cast immobilization and non-weight bearing on bone loss has not been well studied. The purpose of this case report is to describe the changes in bone mineral density (BMD) of the calcaneus in the feet of a patient with acute neuropathic arthropathy during total contact cast immobilization. CASE DESCRIPTION: The patient was a 34-year-old woman with type 1 DM, renal failure requiring dialysis, and a 7-week duration of neuropathic arthropathy of the midfoot. Intervention included total contact casting and minimal to no weight bearing for 10 weeks, with transition to therapeutic footwear. Ultrasound-derived estimates of BMD were taken of both involved and uninvolved calcanei. OUTCOME: Bone mineral density decreased for the involved foot (from 0.25 g/cm(2) to 0.20 g/cm(2)) and increased for the uninvolved foot (from 0.27 g/cm(2) to 0.31 g/cm(2)) during casting. DISCUSSION: The low initial BMD and further loss during casting suggest the need for transitional bracing and a well-monitored return to full activity to minimize the risk of recurrence and progression of foot deformity.
Authors: H K Genant; C Cooper; G Poor; I Reid; G Ehrlich; J Kanis; B E Nordin; E Barrett-Connor; D Black; J P Bonjour; B Dawson-Hughes; P D Delmas; J Dequeker; S Ragi Eis; C Gennari; O Johnell; C C Johnston; E M Lau; U A Liberman; R Lindsay; T J Martin; B Masri; C A Mautalen; P J Meunier; N Khaltaev Journal: Osteoporos Int Date: 1999 Impact factor: 4.507
Authors: E J Petersen; S M Irish; C L Lyons; S F Miklaski; J M Bryan; N E Henderson; L N Masullo Journal: J Orthop Sports Phys Ther Date: 1999-10 Impact factor: 4.751
Authors: M Arici; H Erturk; B Altun; C Usalan; S Ulusoy; Y Erdem; A Sivri; U Yasavul; C Turgan; S Caglar Journal: Nephrol Dial Transplant Date: 2000-11 Impact factor: 5.992
Authors: David R Sinacore; Mary K Hastings; Kathryn L Bohnert; Faye A Fielder; Dennis T Villareal; Vilray P Blair; Jeffrey E Johnson Journal: Phys Ther Date: 2008-09-18
Authors: Frank C Ko; Marie Mortreux; Daniela Riveros; Janice A Nagy; Seward B Rutkove; Mary L Bouxsein Journal: NPJ Microgravity Date: 2020-05-18 Impact factor: 4.415
Authors: Paul K Commean; Kirk E Smith; Charles F Hildebolt; Kathryn L Bohnert; David R Sinacore; Fred W Prior Journal: J Clin Densitom Date: 2017-06-28 Impact factor: 2.617
Authors: Paul K Commean; Jared A Kennedy; Karen A Bahow; Charles F Hildebolt; Lu Liu; Kirk E Smith; Mary K Hastings; Tao Ju; Fred W Prior; David R Sinacore Journal: J Clin Densitom Date: 2011-07-01 Impact factor: 2.617
Authors: Galateia J Kazakia; Willy Tjong; Jasmine A Nirody; Andrew J Burghardt; Julio Carballido-Gamio; Janina M Patsch; Thomas Link; Brian T Feeley; C Benjamin Ma Journal: Bone Date: 2014-03-03 Impact factor: 4.398
Authors: David R Sinacore; Mary K Hastings; Kathryn L Bohnert; Michael J Strube; David J Gutekunst; Jeffrey E Johnson Journal: Bone Date: 2017-09-20 Impact factor: 4.398
Authors: Mary K Hastings; Jeffrey E Johnson; Michael J Strube; Charles F Hildebolt; Kathryn L Bohnert; Fred W Prior; David R Sinacore Journal: J Bone Joint Surg Am Date: 2013-07-03 Impact factor: 5.284
Authors: David R Sinacore; Kathryn L Bohnert; Kirk E Smith; Mary K Hastings; Paul K Commean; David J Gutekunst; Jeffrey E Johnson; Fred W Prior Journal: J Diabetes Complications Date: 2017-02-14 Impact factor: 2.852