CHARCOT NEUROARTHROPATHY: WHAT IS IT?

Understanding Charcot Joint Disease

Charcot joint disease, or Charcot foot, is a condition that can significantly affect individuals with peripheral neuropathy, particularly those with long-standing diabetes. The initial signs and symptoms of Charcot often present as a sudden onset of severe swelling, redness, and warmth in one foot and/or ankle, contrasting with the opposite lower extremity. While pain may accompany these symptoms, it is frequently absent due to the effects of neuropathy. Given the potentially devastating consequences of neglected Charcot, it is crucial to contact one of the foot and ankle specialists at the Foot and Ankle Center of Iowa if you suspect you are experiencing an acute Charcot event.

Causes and Consequences

Charcot is caused by a cascade of events triggered by peripheral neuropathy, abnormal control of blood vessel tone, and an unmediated inflammatory response. This process can lead to destructive changes, including multiple fractures, dislocation and collapse of joints, and often severe, permanent deformities of the foot and/or ankle. As a result of these deformities, the bottom of the foot may no longer be flat due to prominent bones from the collapsed joints. Walking unprotected on these prominent bones can create excessive pressure on the skin, which may lead to ulceration. In fact, approximately 63% of individuals who experience a Charcot event will also develop an ulceration.

Diagnosis and Initial Treatment

The podiatrists at the Foot and Ankle Center of Iowa are well-versed in recognizing Charcot and can identify if you are experiencing an acute event. Initial treatment typically involves obtaining x-rays, breaking the cycle of unmediated inflammation, and minimizing the degree of bone and joint destruction. To achieve this, your foot and ankle specialist will likely place you in a cast or surgical boot and will instruct you to keep weight off the affected foot completely until further notice. This initial stage of treatment often lasts several weeks. During this time, your foot doctor will closely monitor your condition with routine follow-up visits until clinical and x-ray examinations indicate that the process has stabilized.

Transitioning to Long-Term Care

Once stabilization is achieved, you may be transitioned into a customized orthotic boot or shoe, depending on the degree of deformity. However, in some cases, the deformity may be too unstable to manage with an orthotic device. Additionally, if prominent bones lead to ulcers that are unresponsive to treatment or continue to recur, your foot and ankle surgeon may recommend surgical intervention. If you believe you are suffering from Charcot, Foot and Anke Center of Iowa at 515-639-3775 to schedule an appointment with one of our foot and ankle specialists who can provide you with the specialized care you need.