Charcot foot is a deformity that results from nerve damage (neuropathy) in the foot or ankle. The nerve damage causes a loss of sensation that increases the risk of injury to the feet. When the foot is repeatedly injured, the weight-bearing joints start breaking down.
If a person suffers from especially bad neuropathy, the sensation in their feet and their sense of balance may be affected. As the sufferer walks off-balance and in an unnatural way, the joints in the foot can eventually collapse.
What Causes It?
Typically developing over a period of time, Charcot foot requires a number of factors to occur.
If you have been diagnosed with diabetes mellitus and or peripheral neuropathy, you are at risk of developing Charcot foot. Neuropathy is one of the leading causes of this condition, as it diminishes the patient’s ability to feel pain, temperature, or trauma. Because of this decrease in sensation, the patient usually does not realise they have the condition. They continue walking on the untreated foot, ultimately causing the situation to worsen. Neuropathic patients, who have a tight Achilles tendon, are also prone to developing it. Diabetes and hyperglycaemia (high levels of glucose in the blood), can trigger neuropathy, which can lead to Charcot foot. How this occurs is still unknown.
The trigger for Charcot foot can be a sprain or twisted ankle that goes unnoticed because of reduced feeling from nerve damage. If the person continues to place pressure on the foot through walking, the injury can worsen and could lead to dislocation or fractures in one or more bones of the foot or ankle.
These may include:
People with diabetes should report any signs of foot damage to their doctor or podiatrist as soon as possible, as they could develop and become much more serious as a result of neuropathy. More serious foot conditions can lead to osteomyelitis (a bone infection), or lead to amputation if not treated by a doctor, podiatrist, or specialist.
Diagnosing Charcot Foot
In order to properly treat Charcot foot, you’ll need to have your symptoms checked out immediately. Catching this condition in its early stages is critical to successful treatment, so you should see a podiatrist at the first sign of symptoms. Diagnosis can sometimes be difficult because this condition can mimic other conditions like cellulitis, or deep venous thrombosis, and because as well diagnosis of a Charcot fracture cannot be made definitively until bone changes occur. Therefore traditional methods for early detection (x-rays, MRIs, CT scans, etc) are sometimes not as useful as a nuclear bone scan.
Your doctor or podiatrist will need to examine your feet and ask questions about your recent activities, symptoms you are having, and your medical history. X-rays and other imaging tests may be needed to diagnose you properly. Once the diagnosis is made, you’ll need to have regular exams to keep track of the condition. Your doctor may draw fluid from your joint for laboratory testing to check for fragments of bone and cartilage. Once you are properly diagnosed, your doctor or podiatrist will create an appropriate treatment plan based on the cause and severity of your condition.
It is treated by reducing pressure on the foot, and wearing a plaster cast to allow the foot to set and heal in the correct position. Whilst your foot is healing, you will need regular appointments with a podiatrist and regular x-rays would have to be done.
Recovery from Charcot Foot
During the recovery of the affected foot, check your other foot for any signs of damage or strain, as this foot is likely to be taking more pressure whilst the other one heals. Depending on how much damage has been sustained, you may experience a change of shape in your foot.
Your feet mirror your general health . . . cherish them!