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Charcot Arthropathy

It is a condition caused by weakening of the bones in the foot along with neuropathy or loss of sensation. Most common causes of charcot is diabetes. Other causes include syringomyelia, alcoholism, tabes dorsalis, steroids, infection, trauma etc. Diabetes causes changes in circulation which leads to weakening of the bones and increased sugar in your body will eventually lead to neuropathy. When there is repititive trauma on foot with weak bones and neuropathy, it leads to fractures and dislocations therefore causing Charcot deformity. Charcot arthropathy may affect any part of the foot and ankle, including the midfoot, hindfoot, ankle, heel and forefoot. Multiple regions may be involved concurrently.

​Symptoms of charcot include swelling, redness and increased warmth of the foot and ankle. Later, when fractures and dislocations occur, there may be severe deformities of the foot and ankle, including collapse of the midfoot arch (often called rocker bottom foot) or instability of the ankle and hindfoot.

Time between onset of symptoms and diagnosis may be several weeks or months. Because of bony deformities and neuropathy, some patients can also develop ulcerations on their foot and ankle. Early radiographs may show soft tissue swelling with no bony changes, but repeat radiographs (several weeks after) may show bone and joint changes. If caught early, charcot can be treated conservatively. Initial treatment will include non-weightbearing. Once, stable charcot can be controlled by wearing accomodative footwear with protective orthoses. In patients with severe deformity and instability, surgery is recommended.