Neuropathic Osteoarthopathy of the Foot or Charcot Foot”

Written by: Jon Moessner, BS, PMAC

Charcot foot is a disorder in which the bones of the foot begin to soften and eventually fracture leading severe foot deformity, disability, and possible amputation of the affected foot.  Individuals with Charcot foot may also develop ulcers on their feet. Charcot foot is caused by neuropathy, a decrease in sensation in the extremities. Neuropathy is very common among diabetics and Charcot foot is one of possible complications.

A Charcot foot occurs as a result of neuropathy. Individuals with severe neuropathy have little to no feeling in their feet and are unlikely to notice injury to their feet and will continue to walk and make the initial injury worse. Since the individual is not aware of any injury they will continue to reinjure their foot resulting in a progressive break down of the bone in the foot.

Charcot foot is a serious condition and it is important that the disease is detected early to prevent some of the more severe complications associated with Charcot foot. The American College of Foot and Ankle Surgeons list several possible signs of Charcot foot, including: redness in the foot, swelling in the foot, pain or soreness, and warmth to the touch (One foot is warmer than the other). Individuals who are diabetics are at an increased risk of developing a Charcot foot because of the high incidence of neuropathy in diabetics. As such it is important especially for diabetics to be examined for signs of a Charcot foot.

Charcot

Above is an x-ray of an end stage Charcot foot

Charcot foot is typically diagnosed by physical examination in conjunction with x-rays. In some cases, imaging and lab work may be ordered to facilitate a diagnosis. Following diagnosis there are several parts involved in treatment of a Charcot foot. Typically immobilization of the foot is recommended. This is done to allow the damaged bones to heal. Immobilization of the foot includes non-weight bearing on the affected foot. The doctor may recommend a boot and crutches or a wheelchair to completely immobilize the foot. Custom shoes and inserts may be recommended to help prevent future injury of the foot and the development of ulcers. The doctor may also recommend activity modification prevent Charcot foot from developing in the other foot. In some cases surgery may be necessary to correct the damage and deformity to the foot. Preventative care is also an important factor. Diabetic patients should keep their blood sugar levels under control. Regular check-ups are also important to prevent or catch an early stage Charcot foot. It is important to identify an active Charcot process.

If you have any concerns, or you think you are showing symptoms, it is critical to contact your podiatrist to schedule an exam.