Radiological evaluation of tarsal disintergration in leprosy

ABSTRACT

Tarsal Disintegration [TD] is a known entity occuring exclusively in neuropathic foot of leprosy. It is a complex and less understood phenomenon influenced by many factors among them the disease itself, altered gait due to sensory and muscular paralysis resulting in repeated trauma. In this study conducted in the Department of Radiology, C.M.H., Rawalpindi in collaboration with Rawalpindi Leprosy Hospital, these factors were studied in detailed radiologically. It was found that sensory loss and muscular paralysis due to disease, results in changes in weight bearing and weight transmission in feet during standing and propulsion which constitute one of the major factors in occurrence and progression of T.D. Early detection of bony changes that can lead to T.D. is very crucial. By periodic check x-rays of the feet for soft tissue and bones with and without weight bearing, the radiologist can help the treating doctor, to take preventive and curative measures. Fissuring in the fibro-fatty layers of the sole causes infection of soft tissue and may result in osteomyelitis of already compromised bones and can results in occurrence and progression of TD, if preventive and curative measures are not adopted and followed on war footing along with health education