Charcot Foot, or as technically known Charcot Neuropathy, is a degenerative condition of joints responsible for bearing weight. These joints are sometimes known as Charcot joint. This is a condition wherein sudden softening of foot bones is recorded in patients who suffer from neuropathic issues (nerve damages). Initially neuropathy of knees was determined to occur due to syphilis while shoulder neuropathy occurred due to syringomelia. Nowadays the condition is also recorded in patients suffering from diabetes mellitus. Charcot foot causes the bones to become fragile enough to fracture and if walking is continued the foot may change its shape eventually. Charcot foot can prove to be a serious medical irregularity as it may lead to adverse consequences such as deformity, disabilities of foot or even amputation. Since, it is serious and common in diabetic individuals it is essential for them to prevent the condition from occurring.
Charcot foot usually goes unrecognized, especially during its acute phase, until severe difficulty is experienced. Diagnosing and addressing the condition can help in significantly reducing the associated complication that may occur. If poorly handled, Charcot foot can also lead to disastrous consequences such as amputation of foot as mentioned earlier. In usual causes acute irregularity caused due to Charcot foot is mild and painless.
Origination and development of Charcot Foot
There are two theories considered for Charcot foot pathogenesis. The first is neurotraumatic which attributes destruction of bones along with loss of sensation of pain as well as interoception loss. In this case repetitive and mechanical trauma to the affected foot is also recorded. The second theory of neurovascular possibilities indicates that degradation of joint can be secondary to primarily caused involuntarily stimulated vascular reflux. This may lead to hyperemia as well as periarticular ostopenia along with contributive trauma. Intrinsical imbalance of the muscles along with augmented heel and plantar pressure may cause eccentric load on the foot. This may aggravate the bony destruction further, increasing the micro-fracture and laxity of ligaments.
Charcot foot develops as a result of neuropathy which causes decrease in ability to feel temperature and sensation. This disability to experience pain and irregularity of the foot caused due to neuropathy causes the condition to aggravate and turn into Charcot foot especially in people who have had it for long time. Studies indicate that neuropathy with tight Achilles tendon tends to aggravate to Charcot foot.
Symptoms of Charcot foot
Charcot foot symptoms may occur due to sudden trauma or even due to repetitive trauma such as walking consistently despite of underlying irregularities. Sudden trauma would include accidents such as dropping heavy objects on the foot, sprain on the foot or even fracture. Symptoms of this condition can be similar to complications experienced due to infections. Though Charcot foot and infection are extremely dissimilar medical irregularities both are considered as serious anomalies that need medical aid. Some common symptoms of Charcot foot are:
- Warm foot which means the foot feels warmer when touched as compared to the other
- Foot becoming redder
- Swelling in the affected foot region
- Soreness or pain
Diagnosis of Charcot foot
Diagnosing Charcot foot earlier is beneficial and extremely important to treat the disorder efficiently. The doctor would first physically analyze the affected area such as ankles, deformities if any and the entire foot. He my probe you on the symptoms and any events that occurred before the symptoms were experienced. The expert may suggest you X-ray examination which is an essential part of Charcot foot diagnosis. In some situations further examinations may be required which involves advanced imaging techniques. Along with the ongoing treatment patient will be asked to undergo X-ray test periodically. This would help in analyzing the effect of treatment and alleviation in the condition.
Treatment of Charcot Foot
It is crucial to thoroughly follow instructions of your doctor to treat Charcot foot. Failure of following the treatment plan can lead to further complications causing, deformity or even amputation of the foot. The treatment of this condition usually involves:
Immobilization: The foot and ankle are extremely fragile during the initial stages of Charcot foot. Hence, one should try to exert no or minimal pressure or strain on the foot. Immobilizing the foot would protect the foot from further injuries and allow the soft bones to repair themselves. It is essential to void weight from the foot in order to prevent foot from collapsing and respond to the treatment. The patient should be strictly barred from walking unless the doctor determines and instructs that it is safe to be move around. During the immobilization the patient’s foot will be installed with a cast, boots or braces. If necessary, doctor will recommend using crutches or wheelchair. Usually the bone takes several months to heal but in some individuals it may take longer than that.
Custom Shoes and braces: After the bones are healed, shoes with specific inserts may be required which would allow patients to gradually resume to daily activities. This would also help in preventing recurrence of Charcot foot, ulcer development and amputation. Bracing is suggested in case severe deformity is recorded.
Modification in regular activities: The patient may have to turn down certain activities that causes trauma to feet. This is because there are chances that the affected patient may probably develop the condition in the other foot as well. In fact people with Charcot foot are more prone to develop the condition in the other foot as compared to others. Thus measures must be taken from preventing such complications.
In some severe cases surgery may be necessary. Specialized surgeon skilled in ankle and foot surgery will determine the best suitable procedure according to the case at hand. There are certain considerations that are kept in mind while determining which surgery will suit best for example severity of the condition, level of deformity and complication, age of the affected person, overall health and underlying medical conditions.
Diabetes patient should be careful and measure their blood sugar level to maintain it under control. This may prevent progression of the condition. If suffering from even minor foot irregularity get it diagnosed and under regular check-ups if necessary. Take proper care of your feet in general; this would help in minimizing the risk of Charcot foot.
Charcot Foot – Pictures