Some patients with leprosy experience disintegration of the tarsal bone, resulting in a serious foot deformity and disability. If detected early it can be successfully managed.
Risk factors for tarsal disintegration:
(1) osteoporosis secondary to increased bone resorption
(2) osteoporosis associated with corticosteroid therapy
(3) repetitive trauma with microfractures or stress fractures
(4) neuropathy with loss of vibration and pressure perception
(5) altered biomechanics
(6) avascular necrosis
The patient may present with:
(1) heat and swelling over the ankle and foot without infection
(2) absence of pain
Imaging studies show progression over time with:
(1) small fractures, chips or cracks
(2) decreased bone density
(3) bone fragmentation
(4) partial or complete collapse
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