FEATURES OF BONE METABOLISM AND THE ROLE OF MRI IN THE DIAGNOSIS OF CHARCOT'S FOOT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

The aim of the study was to study the role of MRI and the state of bone metabolism in the diagnosis of Charcot's foot in patients with diabetic osteoarthropathy at an early stage. Research materials and methods: 45 patients were examined (prospectively) with type 2 diabetes and Charcot's foot in the period 2021-2022 at the Academician E.H. Turakulov Endocrinology Research Center , in the department of diabetic foot. All observed patients were divided into 4 groups: 1 gy - patients with acute stage of Charcot's foot with type 2 diabetes - 25 patients, Group 2 - patients with the subacute stage of Charcot's foot - 20 patients, The control group consisted of 20 persons with DM 2 without VDS. Of the 45 patients, there were 37 men and 8 women. The average age: men was 69.12 years, women - 68, 15 years. The prescription of type 2 diabetes ranged from 17 to 25 years. The research methods included: biochemical (bilirubin, direct, indirect, lipid spectrum, ALT, AST, PTI, coagulogram, blood sugar, glycated hemoglobin, urea, creatinine, GFR, calcium, alkaline phosphatase, parathyroid hormone, vitamin D3, blood and instrumental: ECG, MRI of the feet, dopplerography of the main vessels of the legs, Ultrasound of internal organs, DEHA, fundus. The results of the study. On the MRI, we found the location of the bone marrow abnormality (edema shown in fluid-sensitive and recovery of fatty bone marrow shown in T1 sequences). The pattern tended to be periarticular. All patients had several joints and bones involved (mainly tarsometatarsal joints and metatarsal joints). In the late stages of Charcot's foot, the appearance of severe pathological changes (bone destruction, massive effusion, etc.) is characteristic on MRI. Early stage of Charcot's foot CT (computed tomography) It does not play an important role for visualization, since changes in bone marrow and soft tissues can be better visualized using MRI ( magnetic resonance imaging). CT can be used in the later stage of Charcot's foot for better visualization of bone proliferation and consolidation. Diagnosis of this disease in the early stages contributes to the timely initiation of appropriate therapy and helps to minimize the disability of these patients. In the late stages of Charcot's foot, the appearance of severe pathological changes (bone destruction, massive effusion, etc.) is characteristic on MRI Conclusions 1. Patients with diabetic foot syndrome complicated by Charcot's foot are at high risk of deficiency of 25-hydroxyvitamin D3 and calcium. 2) An early symptom on MRI with Charcot's foot was the presence of concavity of the articular surface of the talus bone against the background of sclerosis in the talus-navicular joint.