Charcot Foot: Identifying A Rare Diabetic Foot Condition
Rare Diabetes Foot Complication Becomes More Common in Milwaukee, Wisconsin
As diabetes rates soar nationwide, a Milwaukee foot and ankle surgeon says he’s now seeing more patients with a rare, and very serious, diabetic foot complication.
Charcot foot (pronounced SHAR-co) is an inflammatory syndrome affecting both the bones and soft tissues in the foot and ankle. Dr. Jay Christensen, DPM, says it is characterized by uncontrolled inflammation leading to a sudden softening of the foot’s bones.
This can trigger an avalanche of problems, including joint loss, fractures, collapse of the arch, massive deformity, ulcers, amputation, and even death.
“As the foot’s structure collapses, the bottom of the foot can become convex, bulging like the hull of a ship,” says Dr. Christensen.
This well-known deformity of Charcot foot is commonly known as “rocker-bottom” foot. Patients at this stage in the disorder sometimes experience pain or discomfort, however Dr. Christensen explains, “Diabetes patients frequently won’t feel any pain because they have severe nerve damage in their lower extremities.”
In fact, the loss of sensation from nerve damage (neuropathy) is what results in Charcot foot in some patients. When neuropathy is present, foot bones are weakened and you’re at greatly increased risk of injury. If you repeatedly injure your foot, weight-bearing joints begin to deteriorate.
Few People with Diabetes Know the Warning Signs of This Limb-Threatening Foot Condition
The onset of the condition is often triggered by a minor injury or other causes of local inflammation. A recent foot surgery, infection, or existing ulceration can all be gateways for Charcot foot.
Dr. Christensen says every person with diabetes should know the Charcot foot warning signs: redness, heat, and swelling in the foot or ankle. Symptoms often start out mild and then become much more pronounced.
Over time, the deformity can cause bony protrusions which in turn lead to calluses and foot ulcers and cause pressure inside the patient’s shoes. If an ulcer becomes infected it may spread to the bones and joints. Symptoms of this infection (septic arthritis) include tiredness and fever.
Treatment of Charcot Foot
Some drugs have been proven beneficial in managing Charcot foot. However the main concern is preventing further deterioration of the foot joints and minimizing the progress of the deformity.
Stabilizing the foot and ankle is key, and in most cases a “Charcot shoe” or “Charcot boot” is fitted to relieve pressure and protect from further damage.
Severe cases of Charcot foot may require surgery to reshape the deformity. This can include removing a bony protrusion or realigning bones of the feet by fusing joints.
Preventing Charcot Foot
Charcot cannot be reversed, but its destructive effects can be stopped if the condition is detected early.
Diabetic patients play a vital role in preventing Charcot foot and its complications - you must be proactive and seek a professional when you experience foot pain!
Diabetes patients should keep blood sugar levels under control. This has been shown to reduce the progression of nerve damage in the feet. People with diabetes should also inspect both of their feet every day, and get regular check-ups from a foot and ankle surgeon.
When to See a Foot and Ankle Specialist
Several other dangerous conditions, such as deep vein thrombosis and acute infections, share Charcot foot’s symptoms: redness, heat, and swelling in the foot or ankle. A patient with these warning requires emergency medical care.
The American College of Foot and Ankle Surgeons (ACFAS) estimates less than one percent of people with diabetes develop Charcot foot. But nationwide, the College’s 6,800 members say they’re noticing more Charcot cases as more Americans develop diabetes.