Follow‐Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long‐Term Outcomes: A Retrospective Cohort Study

ABSTRACT Aims/Hypothesis Charcot foot (CF), a potentially debilitating complication of neuropathy, requires offloading to avoid foot deformities. Follow‐up MRI examinations are often used to determine the optimal duration of total contact cast (TCC) offloading treatment. This study investigated the...

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Main Authors: Johan Schoug, Per Katzman, Erik Uddman, Magnus Löndahl
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Journal of Foot and Ankle Research
Subjects:
Online Access:https://doi.org/10.1002/jfa2.70058
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author Johan Schoug
Per Katzman
Erik Uddman
Magnus Löndahl
author_facet Johan Schoug
Per Katzman
Erik Uddman
Magnus Löndahl
author_sort Johan Schoug
collection DOAJ
description ABSTRACT Aims/Hypothesis Charcot foot (CF), a potentially debilitating complication of neuropathy, requires offloading to avoid foot deformities. Follow‐up MRI examinations are often used to determine the optimal duration of total contact cast (TCC) offloading treatment. This study investigated the use of follow‐up MRI during CF treatment and its relationship to offloading duration and risk of future surgery. Methods People with diabetes mellitus and MRI‐confirmed CF treated at Skåne University Hospital (Lund and Malmö, Sweden) between 2006 and 2022 were studied retrospectively. Individuals monitored with follow‐up MRI examinations were compared with those who only underwent diagnostic MRI. A regression model was applied to evaluate factors predicting TCC and total CF treatment duration. Results One‐hundred and twenty‐two individuals (45 [37%] DM1; 47 [39%] women; median age 60 [IQR 53–68] years) with a total of 143 CF events were included. 76 (53%) of these CF events were monitored using a total of 141 follow‐up MRI examinations. Individuals monitored with MRI had significantly longer TCC and total CF treatment durations (p < 0.001). Individual characteristics (with the exception of sex), rate of stage 1 CF, and risk of future surgery did not differ between the two groups and only use of follow‐up MRI (p < 0.001) remained a significant predictor of both longer TCC and total CF treatment durations in a regression model. Conclusions/Interpretation In this retrospective cohort study, use of follow‐up MRI was associated with longer TCC and total treatment times despite similar characteristics and outcomes. Prospective studies are needed to further elucidate the optimal use of MRI in monitoring CF.
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spelling doaj-art-d2a449cd7ee9444b88a3fe6a2e1033fa2025-08-20T02:21:58ZengWileyJournal of Foot and Ankle Research1757-11462025-06-01182n/an/a10.1002/jfa2.70058Follow‐Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long‐Term Outcomes: A Retrospective Cohort StudyJohan Schoug0Per Katzman1Erik Uddman2Magnus Löndahl3Department of Endocrinology Skåne University Hospital Lund SwedenDepartment of Endocrinology Skåne University Hospital Lund SwedenDepartment of Endocrinology Skåne University Hospital Lund SwedenDepartment of Endocrinology Skåne University Hospital Lund SwedenABSTRACT Aims/Hypothesis Charcot foot (CF), a potentially debilitating complication of neuropathy, requires offloading to avoid foot deformities. Follow‐up MRI examinations are often used to determine the optimal duration of total contact cast (TCC) offloading treatment. This study investigated the use of follow‐up MRI during CF treatment and its relationship to offloading duration and risk of future surgery. Methods People with diabetes mellitus and MRI‐confirmed CF treated at Skåne University Hospital (Lund and Malmö, Sweden) between 2006 and 2022 were studied retrospectively. Individuals monitored with follow‐up MRI examinations were compared with those who only underwent diagnostic MRI. A regression model was applied to evaluate factors predicting TCC and total CF treatment duration. Results One‐hundred and twenty‐two individuals (45 [37%] DM1; 47 [39%] women; median age 60 [IQR 53–68] years) with a total of 143 CF events were included. 76 (53%) of these CF events were monitored using a total of 141 follow‐up MRI examinations. Individuals monitored with MRI had significantly longer TCC and total CF treatment durations (p < 0.001). Individual characteristics (with the exception of sex), rate of stage 1 CF, and risk of future surgery did not differ between the two groups and only use of follow‐up MRI (p < 0.001) remained a significant predictor of both longer TCC and total CF treatment durations in a regression model. Conclusions/Interpretation In this retrospective cohort study, use of follow‐up MRI was associated with longer TCC and total treatment times despite similar characteristics and outcomes. Prospective studies are needed to further elucidate the optimal use of MRI in monitoring CF.https://doi.org/10.1002/jfa2.70058Charcot arthropathycohortdiabetic footmagnetic resonance imagingtreatment
spellingShingle Johan Schoug
Per Katzman
Erik Uddman
Magnus Löndahl
Follow‐Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long‐Term Outcomes: A Retrospective Cohort Study
Journal of Foot and Ankle Research
Charcot arthropathy
cohort
diabetic foot
magnetic resonance imaging
treatment
title Follow‐Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long‐Term Outcomes: A Retrospective Cohort Study
title_full Follow‐Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long‐Term Outcomes: A Retrospective Cohort Study
title_fullStr Follow‐Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long‐Term Outcomes: A Retrospective Cohort Study
title_full_unstemmed Follow‐Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long‐Term Outcomes: A Retrospective Cohort Study
title_short Follow‐Up Magnetic Resonance Imaging in Monitoring Charcot Foot and Its Association With Total Contact Cast Treatment Duration and Long‐Term Outcomes: A Retrospective Cohort Study
title_sort follow up magnetic resonance imaging in monitoring charcot foot and its association with total contact cast treatment duration and long term outcomes a retrospective cohort study
topic Charcot arthropathy
cohort
diabetic foot
magnetic resonance imaging
treatment
url https://doi.org/10.1002/jfa2.70058
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