Charcot Foot is a Serious Foot Disorder

By: Allan Tan

Charcot's foot is a condition that is often identified with diabetes, is
used to describe the effect of bone softening that happens within the
foot internally. The trigger for Charcot's foot is almost always your loss
of ability to feel or sense pain. This occurs as a result of neuropathy or
extreme nerve damage. The bones become very fragile and eventually
become very likely to be fractured. Because the nerves have become
too damaged, stimuli are no longer being transmitted such as feelings
of pain. In addition, muscle movement is also hampered. Charcot's foot
is highly dangerous without early and proper treatment.

As the person continues to use his or her feet for walking despite the
condition, the foot begins to change its shape. In its progressed stage,
the arch of the foot will collapse therefore giving the foot a rocker-
bottom shape. Due to that reason, even normal walking can become
very painful and difficult.

Charcot foot is a very serious degenerative condition which can lead to

disability and if not treated immediately, can result to foot amputation.

Charcot's foot is highly prone to patients with diabetes. This is because

diabetes is highly associated with neuropathic occurrences which are
the primary factor for exhibiting Charcot foot. Preventive measures are
thereupon enforced and immediate medical attention is sought upon
the occurrence of any symptoms.

So what are the signs and symptoms of Charcot foot?

Initial signs may begin to appear after the foot suffers from repeated
trauma. This trauma may be caused by lengthy walking or any other
high-impact activity which puts great pressure on the feet. Even
accidents-causing objects to be dropped on the foot or fractures can
also lead to foot trauma.

Once Charcot foot becomes triggered, the following symptoms may be

observed: - The affected area becomes warmer than the other foot.

- A recurring redness can be seen on the foot area.

- Swelling becomes evident.

- A certain pain or sore feeling begins to happen.

- Joint dislocation is evident upon X-ray results

- A strong pulse suddenly develops.

- The bones become misaligned.

- The affected foot suddenly becomes numb and insensitive to any

form of sensation.

If you see these signs and symptoms, you must seek immediate
medical help. The GP would start performing survey on your foot and
background checking prior to occurence of the symptoms. A test for
diabetes will also be conducted to rule out any possible effects brought
by the illness.
X-rays may also be done periodically to monitor the development of
the bones. Additional, laboratory tests may also be conducted
depending on the severity of the condition.

In general, the treatment of Charcot foot aims to stabilize the condition

of the joint once more so that the foot can take its original form and
normal walking can be facilitated again. Rest is the primary form of
treatment.

For diabetic patients, foot splints may be used for at least 8 weeks so
that no further damage can occur. Casts or crutches would be needed
to help the patient walk without having to move the affected foot.
Casts and crutches may also be used by other non diabetic patients to
help speed up recovery.

However extreme conditions, like when the joint can no longer do self-
healing, surely need surgical attention. Various procedures are being
conducted according to the severity of the damage.

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From the category archives:

Charcot's Foot
Bone Mineral Density in Charcot’s Neuroarthropathy
http://www.diabetic-foot.com.au/category/charcots-foot/

Charcot's Foot (Charcot's arthropathy or neuroarthropathy)

Information for health professionals on
Charcots neuroarthropathy

What is a Charcot Foot (Charcot's joints; Charcot

arthropathy; Neuroarthropathy)?
Charcot's foot is a complication of diabetes that almost always occurs in those with neuropathy (nerve damage). When
neuropathy is present, the bones in the foot become weakened and can fracture easily, even without there being any
major trauma. As the neuropathy is present, the pain goes unnoticed and the person continues to walk on it. This can
lead to severe deformities of the foot. As this can be very disabling, early diagnosis and treatment is vitally important.

Another way to consider it - imagine spraining your ankle and not knowing you
have done this. You will continue to walk on it - imagine the damage that this
would do. This is what happens in a Charcot foot.

The Charcot's foot should not be confused with the foot deformity that can occur in those with Charcot-Marie-Tooth
disease - they are very different conditions.

Charcot's foot or Charcot disease takes it name from Jean-Martin Charcot (1825-1893) who was the first to describe the
disintegration the occurs to the ligaments and joints. In the medical literature it is often called Charcot's arthropathy or
Charcot neuroarthropathy.

What causes Charcots Foot:

In those with Charcot's foot the ability to sense pain is usually lost or impaired (as a result of diabetic neuropathy). The
muscles lose their ability to support the foot correctly. As a result of this, minor trauma (eg sprains; stress fractures) to
the foot go undetected and do not get treated. This leads to a slackness of the ligaments (laxity), joints being
dislocated, bone and cartilage being damaged and deformity to the foot.

What are the symptoms of Charcot Foot:

The most early signs of Charcot's foot include the foot or affected part of the foot being warmer than the other foot, there
will be some swelling and there may be redness - this is often all that is initially present (this can come on quite
suddenly). There will be no pain and the circulation is usually very good. A deformity then will start to develop (as a
result of joint subluxation/dislocation) as the arch of the foot collapses if the midfoot of the foot is affected and is left
untreated.

In most cases only one foot is affected, but both feet can be affected over time. Generally, the diabetes is usually long
standing and diabetic neuropathy (loss of sensation) is always present and often severe. However, some people with
Charcot's foot can develop a "deep" aching type pain, but it is as never as severe as what would be expected given the
extent of the injury.

Calluses and diabetic foot ulcers may occur as a result of bony protrusions (due to the deformity that develops)
causing pressure inside the shoes. The ulceration can become infected and spread to the bone (stoneflies) and joints
(septic arthritis) - this can cause tiredness and a fever.

What is the treatment for Charcots Foot:

The prevention of further joint destruction and foot deformity is the primary initial aim in treatment of Charcot's foot.
Rest and stabilization of the area are a key. Most cases should be put in a plaster or fiberglass cast ('total contact cast')
to relieve pressure and to prevent further deformity. These need to be replaced periodically until there is no temperature
difference between the two feet. This can take up to 6-9 months. Care needs to be taken of the other foot to prevent
problems developing.

A drug (bisphosphonates) have been shown to be useful as an adjunct in the management of Charcot's foot.

After the Charcot foot has healed specialized footwear and foot orthoses may be needed to prevent it happening again
(this may depend on the extent of deformity). If treatment was not started early enough and/or the foot is deformed, the
possibility of an ulcer developing is high. Prevention with footwear and foot orthoses is then very important.
If the deformity is severe or ulcer recurrence is a problem, surgery can be used to reshape the deformity. This may vary
from a simple removal of a bony prominence to a fusion of joints to realign the foot.
What can you do to help Charcot Foot:
If you have a Charcot's foot, following medical advice is important. Charcot's can be very disabling if not managed early
and properly. Avoid weightbearing as much as possible.

If you do not have Charcot's but have diabetes and neuropathy (loss of sensation), the risk of developing it increases.
Avoid putting yourself in situations that may lead to trauma. Check your feet frequently for any swelling. Do not wait,
seek professional help urgently if you notice any. The 'wait a couple of days to see what happens' could mean the
difference between a good and poor outcome.

http://www.epodiatry.com/charcot-foot.htm

What is Charcot Foot?

Charcot foot is the term given to neurogenic arthropathy that affects the joints in the foot.
Neurogenic arthropathy is a rapidly progressive degenerative arthritis that results from
damaged nerves.

When a person has Charcot foot, their ability to sense pain in their foot is usually lost or
impaired. Their muscles also lose their ability to support the foot properly. In most cases
only one foot is affected. However, both feet can be affected over time.

The bones most often affected in Charcot foot are the tarsals and metatarsals. Charcot foot
occurs most often in people with diabetes.

Patients with Charcot's foot the ability to sense pain is usually lost or impaired . The
muscles lose their ability to support the foot correctly.

Charcot foot is named after Jean-Martin Charcot. Jean-Martin Charcot was the first to
describe the disintegration of ligaments and joint surfaces caused by disease or injury.

What Causes Charcot Foot?

Some common causes of Charcot foot are:

 Chronic hyperglycemia
 Diabetes mellitus

Symptoms of Charcot Foot

 Heat insensitivity in the foot

 Loss of sensation in the foot
 Swelling of the foot and ankle
 Dislocated foot joints
  Weak foot muscles
 Foot ulcers
 Calluses

Complications of Charcot Foot

Patients with Charcot Foot usually do not notice minor traumas to their feet (eg sprains;
strains, stress fractures). The undetected trauma is often untreated and this leads to a
slackness of the ligaments, joint dislocation, a bone and cartilage damage, and deformity to
the foot.

http://www.mamashealth.com/foot/charfoot.asp