Charcot's Foot

Charcot's Foot is also known as Charcot's arthropathy or neuroarthropathy.

What is a Charcot Foot (Charcot's joints; Charcot arthropathy; Neuroarthropathy)?
Charcot's foot is a complication of diabetes that almost always occurs in those with neuropathy. When neuropathy is present, the bones in the foot become weakened and can fracture easily, even without there being any major trauma, the pain goes unnoticed and the person continues to walk on it. This can lead to severe deformities of the foot.
Early diagnosis and treatment is vitally important.
The Charcot's foot should not be confused with the foot deformity that can occur in those with Charcot-Marie-Tooth disease - they are very different conditions.
In the medical literature, it is often called Charcot's arthropathy or Charcot neuroarthropathy.

Causes of Charcots Foot:
In those with Charcot's Foot the ability to sense pain is usually lost or impaired (as a result of diabetic neuropathy). The muscles lose their ability to support the foot correctly. As a result of this, minor trauma (sprains; stress fractures) to the foot go undetected and do not get treated. This leads to a slackness of the ligaments, joints being dislocated, bone and cartilage being damaged, and deformity to the foot.

Symptoms of Charcot's Foot:
The most early signs of Charcot's Foot include:
1 - foot or affected part of the foot being warmer than the other foot,
2 - there will be some swelling and there may be redness
3 - There will be no pain and the circulation is usually very good.
4 - A deformity then will start to develop (as a result of joint subluxation/dislocation) as the arch of the foot collapses if the midfoot of the foot is affected and is left untreated.
In most cases only one foot is affected, but both feet can be affected over time.
However, some people with Charcot's Foot can develop a "deep" aching type pain, but it is as never as severe as what would be expected given the extent of the injury.

Treatment for Charcot's Foot?
The prevention of further joint destruction and foot deformity is the primary initial aim in treatment of Charcot's Foot. Rest and stabilization of the area are a key. Most cases should be put in a plaster or fiberglass cast ('total contact cast') to relieve pressure and to prevent further deformity. These need to be replaced periodically until there is no temperature difference between the two feet. This can take up to 6-9 months. Care needs to be taken of the other foot to prevent problems developing.
Drugs (bisphosphonates) have been shown to be useful as an adjunct in the management of Charcot's Foot.
After the Charcot Foot has healed, specialized footwear and foot orthoses may be needed to prevent it happening again (this may depend on the extent of deformity). If treatment was not started early enough and/or the foot is deformed, the possibility of an ulcer developing is high. Prevention with footwear and foot orthoses is then very important.
If the deformity is severe or ulcer recurrence is a problem, surgery can be used to reshape the deformity. This may vary from a simple removal of a bony prominence to a fusion of joints to realign the foot.

What you can do to help Charcot's Foot?
* Following medical advice is important.
* Avoid weight-bearing as much as possible.
* Avoid putting yourself in situations that may lead to trauma.
* Check your feet frequently for any swelling.
* Do not wait; seek professional help urgently if you notice any of the symptoms above.