Early diagnosis of Charcot foot is essential!

What is Charcot foot?

A disabling and progressive foot disease characterized by neuro-osteoarthropathy, a local inflammation that deteriorates into bone and joint damage. It can lead to joint dislocation and fractures in the foot and ankle that can disrupt walking.

What causes it?

Any condition that can lead to peripheral denervation can cause Charcot foot. This neuropathy increases local inflammation triggered by minor trauma, infection, surgery or ulceration. However, the most common causes are diabetic polyneuropathy and alcoholic neuropathy. Charcot foot affects between 0.1% and 0.9% of diabetic individuals and 63% of patients with this neuro-osteoarthropathy will develop a plantar ulcer. (Dixon J & al, 2017)

Management

A patient presenting inflammatory signs with a sensory neuropathy should be discharged. Early diagnosis and management can reduce the risk of permanent foot deformities. Osteoarticular destruction occurs within four weeks of the onset of symptoms. Your podiatrist will take x-rays.
If they are positive, discharge will be continued until certain criteria are met. When the Charcot is no longer active, the podiatrist will ensure that your footwear is appropriate for your foot.
However, if x-rays are negative, MRI would be helpful for early diagnosis. This imaging allows for visualization of soft tissue and bone marrow inflammation. Other imaging modalities may also be performed. The podiatrist will repeat the x-rays every 4-6 weeks to monitor the progress of your condition.
In addition to immobilization, some patients may require other treatments, such as pharmacological and surgical treatments.

If you are neuropathic with swelling and discomfort in one foot, jumpy pulses, increased local temperature in one foot compared to the contralateral foot, do not delay in seeking prompt attention.

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