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Charcot foot

Charcot foot is primarily caused due to diabetic neuropathy. The nerves of the foot get damaged due to loss of blood flow and subsequently the bones are also weakened. If a person continues to walk with Charcot foot without taking treatment, it can cause change in shape of his foot.

The joints of the foot are seriously damaged and in medical terms this disorder is called neurogenic arthropathy. Since the nerve begins to lose sensation the affected person will not feel any pain on his foot even when it is hurt or damaged. This condition gives rise to serious deformity and change in shape of the foot and hence diabetic patients should regularly check their foot to ensure that there is no nerve damage. There is every chance for the person to get his feet hurt without his knowledge and they will feel very minimal pain. Subsequently the bones begin to regenerate in shape giving rock like appearance on the foot. This in turn makes the muscles to withdraw support for the foot. Charcot foot affects the metatarsal bones of the feet and very often this affects both the feet.

Causes :

The main cause for getting Charcot foot is diabetic neuropathy which reduces the sensation in the nerves. The nerves will not send signals to the brain when there is any injury or pain in the foot. Diabetes is the main cause for getting peripheral neuropathy and the patient will continue walking since there is no pain making the disease to worsen.

Charcot foot can be caused by peripheral neuropathy, spinal cord injury, neurosyphillis and Hansen’s disease.

Normally such neuropathic disorders may take several years to develop, but Charcot foot can progress rapidly within a week or two. Any minor injury to the feet is enough to cause damage to the nerves. Due to repeated carelessness the position of the foot becomes worse which may again cause more injury to the jonts while walking.

An individual with neuropathic problems like Achilles tendon is likely to develop Charcot foot.

Symptoms :

The affected feet becomes tender and warm to touch. There may or may not be swelling in the feet. Very often the pain may not be felt by the person and if at all they feel it only as bearable pain. The affected feet may become red and tender.

There may be hairline fracture on the foot bones. If left untreated, the affected feet may gradually change its shape getting badly deformed. The entire feet develops inflammation and become swollen.

Diagnoses :

It is necessary to diagnose the problem in initial stages to prevent more damage to the joints and bones. Diabetic patients should visit doctor regularly and check the condition of the foot. Your doctor may examine the feet and take X-ray for assessing the extent of damage.

Treatment :

Treatment depends on the intensity of the damage done to the bones and joints of the feet. If diagnosed with the problem of Charcot foot, it is necessary for you to follow the instructions of your doctor. The affected feet should be totally immobilized until the inflammation is healed completely. It may take enough time for the bones to overcome their weakness. One should be very cautious in not damaging the feet in order to prevent further damage or deformity to the foot.

If the surgeon insists on using wheelchair or casting for a while, you should follow his instructions. For some patients removable boots are recommended in the place of braces. Some patients will have to use crutches for balancing the weight and to prevent further damage to the affected feet.

Shoes are available with special insoles to facilitate easy healing of bones. Bracing and customized shoes are given for many people with diabetes. By wearing braces one can prevent the formation of ulcers in the feet which may lead to the amputation of the feet. It would gradually make good the deformed feet.

Lastly one has to make necessary changes in lifestyle to prevent further damage to the affected feet.

In case of severe deformity surgery is done for repairing the joints and bones which have lost shape due to neuropathy.

Pictures of Charcot Foot :

Images, Pics, Pictures and Photos of Charcot Foot

Prevention :

It is easy to prevent and avoid getting Charcot foot by taking preventive measures.

If you are diabetic, monitor the blood sugar levels regularly to reduce the nerve damage. You need to visit foot or ankle surgeon to ensure your foot is in good condition. Check both the feet each day to notice any swelling or tenderness which is indicative of Charcot foot.

Avoid injury or trauma to your feet while walking or running and do not overdo any type of exercises if you are diabetic.

Lastly you should follow the advice of your doctor in wearing castles or braces until the foot are completely healed.

Charcot foot – Pictures, Symptoms, Surgery, Causes, Treatment

What exactly is Charcot foot?

Charcot foot is the medical term given to a condition known as “neurogenic arthropathy” which affects the foot joints. This is a degenerative form of arthritis which rapidly progresses. It causes joint and bone damage that may lead to foot deformities which are severe. This condition starts with “peripheral neuropathy” which is feelings that are decreased in the feet and is most common in diabetics.

Individuals with nerve sensation that is decreased can hurt the feet, causing fractures which are small and since they have feelings which are decreased, may have minimum if any pain. Therefore individuals continue to walk on this injured foot. Because of this the bones begin to unevenly heal which causes the foot to become deformed.

The muscles in the foot will also lose the ability to provide proper support for the foot. In the majority of cases only one foot is affected however, both feet may be affected over time.

With Charcot foot the bones most frequently affected are the metatarsals as well as the tarsals. Charcot foot most often occurs in individuals with diabetes.

Charcot foot was named after an individual named Jean-Martin Charcot. He was the very first individual to describe this degeneration of joint surfaces as well as ligaments caused by injury or disease.

Charcot Foot Causes

There are currently 2 theories about joint destruction with this condition and how it occurs. The first theory is neurotraumatic theory which believes that trauma which is mechanical because of loss of skin sensations as well as loss of pain can lead to destruction of the bone. The other theory is the theory of neurovascular which believes that the combining of trauma together with vascular changes lead to a reduction in osteopenia or mineral density in the bone.

The foot and ankle joint commonly involved include

Tarsometatarsal

Naviculocuneiform joints

Subtalar

Talonavicular or calcaneocuboid joint

Tibiotalar joint

Neuropathic conditions which lead to the condition include

Diabetic neuropathy

NeuroSyphilis

Spinal cord injury

Syringomyelia

Perhipheral nerve injury

Pemicious anemia

Hansen’s disease

There is also a problem with frequent injections of hydrocortisone into the joint which can also lead to joint destruction and to this condition.

Charcot Foot Symptoms

Peripheral neuropathy normally takes decades to develop but the progression of Charcol foot can develop in a couple of weeks or months. Any minor trauma for instance, twisting of the foot, can start the process. Individuals with Charcot foot, the inability to feel pain as well as loss of the sense of the position of the foot will result in joint injuries which are repeated.
The early or acute signs of Charcot foot are:

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Warmer than normal

Redness over area

Small hairline fractures of the foot bones

Swelling over these injured areas

Later – entire foot becomes inflamed as well as swollen

There is very slight if any pain during this time.

Early detection, early diagnosis, total restriction which is immediate as well as lifelong preventive care therapy can generally lessen the probability of complication which can be destructive. If not recognized or not properly managed, Charcot foot can even often lead to amputation. This acute phase often mimics Cellulitis or Deep Vein Thrombosis.

If medical management is not started, the disease develops to the chronic stage. In this stage the following signs may be present:

Foot is deformed and obviously looks unlike the other foot

Arch which is collapsed

Bones which unusually stick out against the skin causing this area of skin to collapse and develop ulcers

Inflammation and swelling of the foot

No pain to intense pain is present

Charcot Foot Treatment

Non-Surgical Treatment – It is enormously important to follow any doctor or surgeon’s plan for treatment for Charcot foot. The failure to do this often can lead to the loss of a foot, toe, leg as well as even their life. Non-surgical therapy for this condition can consist of:

Immobilization
Since the ankle and foot are so very fragile especially during the earlier stages of Charcot, feet must be protected while the weakened bones have time to repair. Total non-weight bearing is a necessity in order to keep the foot from further damage. The individual should not be able to walk on the foot that is affected as least until the surgeon decides if it is safe to do so. It is during this period that the individual needs to be fitted with a removable boot or brace, fitted with a cast or may have to use a wheelchair or crutches. It may take these bones months to heal but this is different in each individual.

Custom bracing and shoes
There may a need to be fitted with shoes that have special inserts after the bones have healed so that the individual can return to normal daily life – as well as prevent any reappearance of this problem, ulcers to develop as well as possibly amputation.

Activity modification
Modification in activities may also be needed to avoid any further trauma to both feet. An individual with Charcot in one foot is very likely to develop in the other foot, so care should be taken to protect both feet.

There are cases where the deformity is so severe that surgery is needed. The ankle and foot surgeon will decide the timing as well as the method which is suitable for each individual case.

The individual must play an important role in preventing Charcot foot and the complications by following the suggestions:

Keep levels of blood sugar controlled in order to help reduce any further development of nerve damage in the feet.

Get regular check-ups from a surgeon of ankles and feet

Check feet daily and see your primary care physician or foot surgeon immediately if you see signs of Charcot foot

Try to avoid any injury such as overdoing an exercise program or bumping the foot

Follow your doctors’ instructions for long term care to prevent any recurrence, ulcers or amputation.