Charcots Neuroarthropathy (CN)

Charcot (pronounced shar-ko) foot is a complete collapse of the bones in the foot and ankle that occurs from neuropathy. Neuropathy is severe nerve damage that can be caused from numerous conditions, most commonly diabetes. With neuropathy, there is a complete loss of sensation in the foot and ankle which allows the bones to become soft. Once this process starts, the foot will begin to change in shape often giving it a rocker-bottom appearance where the arch is actually the lowest part of the foot. This becomes difficult to walk on and is an area of high pressure which then can lead to skin breakdown known as an ulcer.

If you have neuropathy, you should be on the lookout for these signs and symptoms: redness, swelling, the affected foot feels warmer than the other, sometimes pain or soreness. Sounds like an infection, doesn't it! That's right, Charcot changes occur and may often be mistaken for an infection. That is why careful evaluation by our top podiatrist is necessary to be sure you receive the correct treatment. Most commonly, x-rays are taken to see the breakdown of bones in the foot and ankle. With Charcot in the beginning stages, it may be difficult to see on x-ray, so an MRI or CT may be ordered. For advanced changes, the x-rays are unmistakable.

Early detection and treatment for Charcot foot is imperative to prevent skin breakdown that leads to open sores, infection and possible loss of the foot or entire leg*. If there is no open sore or ulcer, the first line of treatment is immobilization and complete non-weight bearing. This allows the bones to fuse and prevent further collapse. When the acute swelling and pain have resolved, a protective brace is custom made for the patient that is worn daily to stabilize the foot and attempt further breakdown. Custom shoes may also be necessary if the foot has severely deformed. In some cases, surgery may be needed to realign the bones of the foot and ankle allowing the patient to walk more efficiently and without prominence that can cause skin breakdown. So how can you prevent this? Regular check ups with your podiatric physician and protective shoe gear are very important. But the most important is checking your feet every day for any changes and avoid injury.

If you have any of these symptoms, call us at Southeast Podiatry to make an appoint with Dr. Brent Harwood or Dr. Brad Egly.