01506nas a2200301   4500000000100000008004100001260001300042653001000055653000900065653002200074653001600096653002800112653001100140653001800151653001100169653001200180653000900192653001600201653001600217100001300233700001100246700001300257245004500270300001000315490000700325520085800332022001401190       1988                            d  c1988 May10aAdult10aAged10aAged, 80 and over10aAnkle Joint10aArthropathy, Neurogenic10aFemale10aFoot Diseases10aHumans10aleprosy10aMale10aMiddle Aged10aRadiography1 aHoribe S1 aTada K1 aNagano J00aNeuroarthropathy of the foot in leprosy.  a481-50 v703 a<p>Among 449 patients with leprosy, 40 had clinical and radiographic evidence of neuroarthropathy in 50 feet. These changes were classified into four types according to the joints first involved by major lesions: ankle (25 feet), midtarsal (15 feet), tarsometatarsal (7 feet) and subtalar (3 feet). The progression of joint destruction was different in each type, but despite the severe destructive changes seen in radiographs, the patients had relatively few complaints. The muscles innervated by the peroneal nerve were severely paralysed in ankle and midtarsal types and it seems that, over a long term, repeated trauma and/or abnormal stress may lead to these types of neuroarthropathy. Neuropathy was less severe in the tarsometatarsal type of joint degeneration; the pathogenesis in this type seemed to be mainly direct trauma to the forefoot.</p>  a0301-620X