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Charcot Foot

What is Charcot foot?

A Charcot foot or Charcot neuroarthropathy is a condition that describes a gradual collapse of the foot in people with sensation loss. Initially a Charcot foot presents as a red, hot and swollen foot that can also be painful. During the acute stage we see bony destruction and resorption followed by foot deformity, often a ‘rocker-bottom foot’.  It is a very serious condition that can result in deformity, ulceration, and in the worst case amputation.

Sensation loss can occur with many health problems including,

  • diabetes
  • Charcot Marie Tooth – a hereditary condition
  • alcoholism
  • vitamin B deficiency
  • kidney failure
  • spinal cord or nerve injury
  • some infections such as HIV
  • some medication

Normal footCharcot foot

 

 

 

 

 

Foot Health Facts, American College of Foot and Ankle Surgeons 2017

What causes Charcot foot?

In severe sensation loss our sensory and motor nerves don’t work properly and we are unable to feel temperature, pressure or pain and our muscles become weak. Our autonomic nervous system also malfunctions affecting our sweat glands, blood vessels. Essentially one or more bones in the foot are unknowingly injured and the person continues to walk on the injury, making it worse.

Increased blood flow from malfunctioning autonomic nerves can also cause the breakdown of bone making the bones weaker and prone to further injury.

Diagnosis of Charcot foot

Early diagnosis of Charcot foot is extremely important for successful treatment. To arrive at a diagnosis, the GP or podiatrist will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays and other imaging studies and tests are ordered to assist with the diagnosis. Once treatment begins, x-rays are taken periodically to aid in evaluating the status of the condition.

Management for Charcot Foot

Image result for charcot foot symptoms

A Charcot foot, if left to run its natural course, undergoes stages which generally involve destruction, reabsorption of bony fragments, and finally a reorganisation of bone into a stable deformed structure. A deformity of the foot can alter the distribution of pressure which can develop into ulcerations at area that experience high levels of force.

Treatment for a Charcot foot is the same as treatment for a broken bone. It requires complete immobilisation of the foot in a cast or brace. If you have diabetes it is also important to get help to manage your blood sugar levels.

To reduce further damage to the foot, minimal weight bearing is recommended until the Charcot process has settled. Medical grade footwear and custom made orthotics are required to accommodate the altered foot shape. Surgical intervention may be required in extreme cases.

A Charcot foot can ‘flare-up’ again at any time so it is very important to maintain regular appointments with a podiatrist for long term management of you feet and footwear.

 

 
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