Developing a biomarker for neuropathic arthropathy in diabetic patients

Neuropathic (Charcot's) arthropathy (NCA) is a complication of diabetes mellitus which, in a high percentage of patients, leads to foot fracture, joint destruction, severe foot deformity, ulceration, instability, and possibly amputation. The development of new treatments is currently limited by the lack of biomarkers that are sensitive and specific indicators of NCA disease onset and treatment outcomes. There is evidence that those with NCA have low foot bone mineral densities (BMDs) and that foot BMDs further decrease during off-loading treatment. We have initiated a repeated measures cohort study in which clinical and radiological data are being collected with the objective to establish volumetric quantitative computed tomography (VQCT)-derived foot BMD as a candidate biomarker for acute NCA. This paper presents the study design, methods and preliminary results.