{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:21:54Z","timestamp":1787840514186,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Charcot neuroarthropathy (CNO) of foot characterised by an increased bone turnover denoted by serological markers of bone resorption. However, histological characteristics of foot bones in people with CNO are not well elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The foot bone samples were collected from patients who had either surgical reconstruction or below-knee amputations for chronic CNO foot (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 10, Group A), unsalvageable diabetic foot ulcer (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 16, Group B), and non-diabetic healthy controls following road traffic accident (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 16, group C). Calcaneum bones retrieved were processed and sections (Haemotoxylin and Eosin, Masson-Goldner stain) evaluated for quantitative histopathological parameters including bony trabeculae number, trabeculae thinning, osteoclast number, Howship\u2019s lacunae, and Haversian canal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean age of participants in the CNO group was 61.6 \u00b1 5.0 and 62.9 \u00b1 6.5 years in diabetic neuropathy group with duration of diabetes 13.1 \u00b1 6.8 and 14.1 \u00b1 9.1 years with HbA1c of 7.6 \u00b1 1.8% and 8.7 \u00b1 2.6 in group A and B, respectively. We observed that normal bone trabeculae were 15% (10\u201337.5) in group A and 60% (47.5\u201382.5) in group B as compared to controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = &lt;0.001). Thin bone trabeculae (%) were observed in 10% (3.5\u201377.5) and 7.5% (0\u201330),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =&lt;0.001), with increased Howship\u2019s lacunae number (1.5 [0.25\u20132] and 1 [0\u20132.25] (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = &lt;0.001)) and increased osteoclast number in group A and B as compared to healthy controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There is an increased bone resorption in CNO causing thinning of bone trabeculae secondary to increased osteoclast numbers and Howship\u2019s lacunae in CNO of foot. Anti-resorptive therapies that target osteoclast activity may be an appealing treatment option for diabetic CNO of foot.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijem.ijem_51_25","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:00:20Z","timestamp":1756278020000},"page":"465-471","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Deciphering Bone Microarchitecture in Diabetic Charcot Neuroarthropathy of Foot: A Case Control Study"],"prefix":"10.4103","volume":"29","author":[{"given":"Raveena","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Endocrinology, PGIMER, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashu","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, PGIMER, Hyderabad, Telangana, 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