PREVALENCE OF RADIOGRAPHIC FOOT ABNORMALITIES IN PATIENTS WITH DIABETES

Clinicians are increasingly aware that mechanical aspects of foot defo rmities, such as Charcot changes, clawtoes, bunion deformities, or cav us or planus foot deformities, might have an impact on the occurrence, potential healing, and recurrence of foot ulcers. We report the preva lence of plain radiographic changes and attempt to rate the severity o f those deformities in the feet of 456 diabetic veteran medicine clini c enrollees. All 456 radiographs were reviewed by orthopaedic surgeons to specifically identify Charcot changes, presence of arterial calcif ication, dislocation of the lesser toe metatarsophalangeal joints, hal lux interphalangeal joint dislocation, and radiographic evidence of pr evious surgery, Radiographs of 428 patients were taken while weightbea ring, and these were reviewed to quantify hallux valgus angles, interm etatarsal 1-2 angles, fifth metatarsal-proximal phalangeal angles, sec ond metatarsal lengths, lateral talocalcaneal and talar-first metatars al angles, and claw toe deformities. The prevalence of Charcot changes was 1.4% (six subjects), and all had radiographic evidence of midfoot Charcot changes. Other deformities, such as clawtoes, hallux valgus, lesser toe joint dislocations, and alterations in arch freight, are mo re common in veterans with diabetes.