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Charcot Foot (Neuroarthropathy)

The Condition

Charcot foot, also referred to as Charcot neuroarthropathy, was first described in the late 1800s. The disease process links foot and ankle neuropathy to ensuing joint degeneration and collapse resulting in severe limb threatening deformities. The loss of sensation and pain perception that occurs in patients results in continued weight bearing and stress of the weakened joints. This leads to bone fractures and further destruction of the joint and soft tissue. After a period of acute inflammation, structural weakening occurs followed by eventual healing or consolidation, at which point the bone is deformed.

The Treatment

Treatment for this severe and disabling condition is necessary to avoid further degeneration and breakdown of the skeletal and soft tissue structures. Surgical and conservative care options are available and vary in complexity depending upon the severity of the injury sustained.

Frequently Asked Questions

Patients that have a history of neuropathy are at risk for developing Charcot neuroarthropathy. Neuropathy may be present for many different reasons including the following: alcoholism, autoimmune disease, diabetes, infections, genetic disorders, vitamin deficiencies or toxicity, chemotherapy medication and environmental exposure to toxins.

The affected area may become red, hot and swollen. Pain and discomfort may be experienced at the area of injury. The foot may have an obvious change in shape or decrease in arch height. Patients may recall a ‘pop’ or ‘snap’ sound originating from the foot prior to symptom onset.

A detailed medical history and physical examination of the foot and ankle are necessary. Plain film radiographs (X-rays), magnetic resonance imaging (MRI) and computerized tomography scan (CT) are typically used to appreciate the extent of the damage.

Yes. Charcot foot increases the risk for limb amputation. Early diagnosis and appropriate treatment are of paramount importance.

Treatment is based upon patient health and the severity of the damage sustained. In some cases, conservative care may be available and typically includes cast or splint immobilization with activity limitation. Surgical care includes the stabilization of any fractures or joint dislocations to restore the normal foot anatomy. This typically requires the use of both internal and external fixation devices to avoid reconstruction failure.