What is Charcot foot?
Charcot foot (pronounced shar-koh) is a condition that affects bones in the foot, primarily in patients with peripheral neuropathy who still have good blood flow to the feet. In this condition, the bones soften and begin to remodel or rebuild in a way that leads to deformity when not treated early enough. Charcot foot may also result in other complications, including amputation of the affected foot or limb, and even death. The condition is named after a French physician named Jean-Martin Charcot, who advanced the study of joints and their diseases 130 years ago.
What causes Charcot foot?
Most cases of Charcot foot deformities are related to mild traumas to the foot, including micro-traumas that can’t be seen by the naked eye. Charcot foot can be caused by bumping the foot against a chair or by placing excessive stress on the foot during exercise or activity. For most patients, the condition will seem to occur out of the blue.
After the initial trauma, the bones of the foot soften and begin to fracture. After about three months of breaking down and fracturing, the bones begin to remodel or heal themselves, but in an improper manner that results in deformity. Usually the deformity occurs mid-foot, resulting in a “rocker bottom” to the foot, almost as if the arch has dropped and become inverted. The foot often also appears wider than normal and misshapen in width.
Charcot foot is a medical emergency
In most cases, Charcot foot is considered a medical emergency because of the ultimate deformity and damage that can occur. Additionally, Charcot foot frequently leads to skin breakdown and ulcerations, which can then trigger serious illness. An otherwise healthy person can become life threateningly ill in a short period of time if the condition is allowed to progress unchecked. Patients may face permanent disability or amputation. In the most severe cases, patients may suffer from organ failure or even death.
Recognizing Charcot foot early
The first sign of Charcot foot is experiencing extremely high temperatures in one foot over the other, accompanied by redness. Pain may or may not be present. Even if the only abnormality visible is swelling, it is crucial to see your podiatrist as soon as possible, even on the same day you first see the changes. Immediately take your weight off your foot, as walking and standing could exacerbate the symptoms and worsen the damage.
It is important to see your podiatrist as soon as possible, even if you have sought emergency department care or have seen your primary care doctor. Patients with Charcot foot have been misdiagnosed by non-podiatrists as having cellulitis (a type of infection), gout, or even blood clots, and an x-ray may appear normal — resulting in an incorrect diagnosis. Your podiatrist is highly skilled at diagnosing Charcot foot and other disorders that a non-podiatrist may miss.
Diagnosing and treating Charcot foot
There is very little home treatment for Charcot foot, and the vast majority of patients require podiatric intervention. Your podiatrist will inspect your feet, ask questions about your activities and health, and may order x-rays or other radiologic studies, as well as blood tests. Conservative treatment usually begins with a cast, rigid boot, or custom boot, and may include use of a wheelchair, crutches, or scooter to take weight off the affected foot. Immobilization of the foot and non-weight bearing measures may take anywhere from three months to a year or more, depending on the severity of the condition. In more severe cases, or for those who do not respond to conservative care, surgery to reconstruct the foot may be necessary.
How to prevent Charcot foot
Those with neuropathy must take care of their feet and follow preventive steps to keep their feet healthy. It is imperative to see your podiatrist right away if you notice any abnormalities such as Charcot foot. Inspect your feet daily and always wear shoes, even in your own house. Shoes are your best defense against foot traumas. In addition, keep your floor and main walkways clear of objects that you might bump with your feet or trip over. Exercise and weight control are important aspects of maintaining health, but consider swimming or using an elliptical machine to avoid repeated high impact to the feet. See your podiatrist regularly for checkups and report any abnormalities right away. If you are diabetic, control your blood sugar as well.
Whether you are experiencing symptoms of Charcot foot, neuropathy, or simply need a check up, please call Kansas City Foot Specialists today at (913)338-4440. We look forward to helping you manage your foot health.