Charcot Arthropathy (Charcot Joint)

Charcot Foot

is a term used for the degeneration of bones and joints. Charcot Foot occurs in people who have lost protective sensation due to nerve damage. The loss of sensation in the feet and hands is called peripheral neuropathy. People who have diseases such as diabetes mellitus may be at risk of developing peripheral neuropathy.

People who have peripheral neuropathy and develop Charcot Foot often will not be aware of the problem until permanent damage has occurred. This page provides information about Charcot Foot, its progression and possible treatments. It is designed to help you understand that the process of Charcot Foot and the treatment are not quick and usually require long-term attention. Successful outcomes depend on proper treatment.

What does Charcot Foot look like?

A Charcot Foot will appear red, hot, and swollen. Pain, deformities, and ulcers may also occur, but because of the lack of sensation, you might not feel anything.

What happens in Charcot Foot?

For people who have nerve damage, the bones in the foot may become weakened and fracture easily. Due to the lack of protective sensation, the person does not feel pain that is normally associated with an injury and may continue to walk on the foot. Further damage and deformity may occur. The deformities of the foot may result in extra pressure on the skin causing ulcers.

The exact cause of a Charcot Joint is not clear. Two factors may work together:

  1. Change in blood flow causes loss of bone strength making the bones brittle and susceptible to fractures
  2. Loss of protective sensation
    Diseases such as diabetes mellitus can cause damage to nerves resulting in loss of feeling in the feet. Injuries such as ankle sprains or small fractures in the bones can go unnoticed. The person will continue to walk on the foot instead of protecting or treating it.

Stages of Charcot Foot:

  • Stage 0 – The only sign of a Stage 0 Charcot Foot is the loss of protective sensation. A person may be identified as “at risk” if they have had an injury such twisting of the ankle. An acute injury or several small injuries may trigger inflammation that is the beginning of the Charcot Foot.
  • Stage 1 – The foot appears red, hot, and swollen, often with no pain. X-rays may show fractures and dislocations of the bones in the foot and ankle. There is a possibility of active destruction and deformity of the bones and joints. If the bones are held in a proper position, less destruction will occur.
  • Stage 2 – The redness, heat, and swelling start to subside. The bones start to heal and form new bone. If the bones are held in a proper position while healing, less deformity will occur.
  • Stage 3 – The redness, heat, and swelling are gone. There may be evidence of boney deformity as the bones continue to heal.

The entire process may last six to twelve months and if a patient is not careful to protect the healing foot, it will take longer.

How is Charcot Foot Treated?