Charcot Foot Diagnosis: What Is Charcot Foot and What Are the Risks?
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Anyone who has experienced foot pain may wonder if they’re going to receive a Charcot Foot diagnosis. Foot pain can be troublesome, frightening, and have an impact on nearly every function, as your feet are responsible for supporting you throughout the day. A Charcot Foot diagnosis and the treatment that follows can make it difficult to enjoy the activities you love. Getting around the house can become challenging.
In this Q&A, Dr. Steven Jasonowicz, an IBJI podiatric foot and ankle surgeon, discusses the symptoms, causes and treatments of Charcot Foot and when a Charcot Foot diagnosis may be given.
What Happens When You Develop Charcot Foot?
Dr. Jasonowicz: Charcot Foot is a condition that occurs in patients with neuropathy (a decrease in the normal sensation in the foot) in which the bones of the foot and ankle weaken and fracture. If not caught early, there is often collapse and deformity of the foot and ankle bones when patients present to the office or hospital.
What Are the Symptoms That May Lead to a Charcot Foot Diagnosis?
Dr. Jasonowicz: If you are experiencing any of these symptoms, you should have your foot evaluated right away.
- A foot/ankle that is red
- A foot/ankle that is hot
- Swollen foot/ankle
- Foot/ankle has a wound
- Pain in foot/ankle
Charcot Foot Diagnosis: Can a Doctor Detect It In One or Both Feet?
Dr. Jasonowicz: In the acute phase it usually occurs in one foot at a time but is not uncommon to see chronic charcot changes in the bilateral feet of patients with neuropathy.
What Might Lead to a Charcot Foot Diagnosis?
Dr. Jasonowicz: While the exact pathophysiology of Charcot is not completely understood/agreed upon, we do know it occurs in those with neuropathy. Neuropathy is most commonly seen in diabetics, although there are many causes of neuropathy seen in those without diabetes.
Is Charcot Foot Painful?
Dr. Jasonowicz: While it can be painful, it is not uncommon to have no pain because of the neuropathy these patients have. It is important that if patients who have neuropathy notice redness, swelling, deformity, wound/ulcer formation or any changes in their feet, they seek an expert right away.
Will Charcot Foot Impede My Daily Activity?
Dr. Jasonowicz: Again, because of the neuropathy, Charcot Foot may not be noticed right away and may not impede daily activity until it is at a more advanced stage.
How Do You Arrive at a Charcot Foot Diagnosis?
Dr. Jasonowicz: A combination between clinical symptoms, X-rays, MRI, and sometimes lab tests or a bone biopsy.
Once You’ve Received a Charcot Foot Diagnosis, What Are the Next Steps?
Dr. Jasonowicz: If caught early enough, it may only require immobilization in a fracture boot but treatment can be more extensive, like a cast with no weight-bearing activities or sometimes surgery to stabilize the foot with something called an external fixator. If there is deformity after the acute phase, sometimes reconstructive surgery is needed to realign the foot to prevent breakdown in the skin/ulceration.
What Are the Complications of Charcot Foot?
Dr. Jasonowicz: If Charcot goes untreated or undiagnosed, it often presents initially with significant deformity and maybe a sore/ulceration. If that ulceration becomes infected, it can sometimes lead to amputation if the infection is too advanced or spreading.
After Charcot Foot Diagnosis: Can It Heal with Treatment?
Dr. Jasonowicz: Even with reconstructive surgery a Charcot Foot is typically never a “normal foot.” It may require a special shoe, boot, brace or insert for life.
What Is the Prognosis Following a Charcot Foot Diagnosis?
Dr. Jasonowicz: This is a tough question to answer, but if caught early, the prognosis is good. Those who have deformity and wounds really need to see a doctor with expertise in Charcot as they are at higher risk for complications and ultimate amputation.
No matter the cause of your foot pain, it may be time to get it looked at by an expert. IBJI’s podiatrists can examine, diagnose and treat your foot pain to get you on the path to recovery.
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