By: Dr. Drew Davidson, DPM
Charcot is a condition that can affect individuals with peripheral neuropathy; especially in those with long-standing diabetes. The initial signs and symptoms of Charcot are sudden onset of severe swelling, redness, and warmth of one foot and/or ankle compared to the opposite lower extremity. While pain may be present with these symptoms, due to the presence of neuropathy, often it is absent. Due to the potential devastating consequences of neglected Charcot, you should contact one of the foot and ankle specialists at Foot and Ankle Center of Iowa to be evaluated should you have concerns that you may be experiencing an acute Charcot event.
Charcot is caused through a cascade of events precipitated by the presence of peripheral neuropathy, abnormal control of blood vessel tone, and an unmediated inflammatory response. This process leads to destructive changes to include multiple fractures (broken bones), dislocation and collapse of joints, and often severe and permanent deformities of the foot and/or ankle. The resulting deformities often lead to the bottom of the foot no longer being flat secondary to prominent bone from the collapsed joints. Walking, unprotected, on the prominent bone leads to excessive pressure on the skin which can lead to ulceration. In fact, around 63% of individuals who experience a Charcot event will also experience an ulceration.
The podiatrists at Foot and Ankle Center of Iowa are knowledgeable about Charcot and will recognize if you are experiencing an acute event. Initial treatment will consist of obtaining x-rays, breaking the unmediated cycle of inflammation, and attempting to minimize the degree of bone and joint destruction that occurs. To accomplish this, your foot and ankle specialist will place you into either a cast or surgical boot and require that you keep weight off of the foot completely until further instructed. This initial stage of treatment often takes several weeks. Your foot doctor will follow you closely with routine follow-up visits until clinical and x-ray exam reveals that the process has stabilized. At this time, depending on the degree of deformity, you will be transitioned into a customized orthotic boot or shoe. In some instances, the degree of deformity is either too unstable to be controlled in an orthotic device or, despite use of an orthotic device, prominent bone leads to ulcers that won’t heal or continue to recur. In these instances, your foot and ankle surgeon may recommend surgical intervention.
If you believe you are suffering from Charcot, contact Foot and Ankle Center of Iowa to be seen by one of our foot and ankle specialists who can provide you with the specialized care you need.