Charcot's Foot is a Medical Emergency.
- Charcot foot is an acute inflammatory condition of the neuropathic foot. There are three classical stages. The first stage leads to bone and joint destruction and fragmentation which if untreated causes foot deformity to develop. The second stage is the coalescive stage during which the destruction process slows and healing commences. A third chronic healed or ‘burnt out’ phase follows the healing process.
- Charcot foot most commonly affects people in their 40s and 50s. The cause is not known but the presentation can follow minor injury. It is commonly misdiagnosed as a sprain or as cellulitis.
- Failure to identify the condition early leads to development of foot deformity which commonly leads to foot ulceration. Typically, ulceration isn’t present in the early stages of Charcot foot although Charcot foot can develop in a previously ulcerated foot. Amputation rates are high in ulcerated Charcot feet. Differentiation from osteomyelitis is very difficult and Charcot foot and osteomyelitis can co-exist
- Charcot foot should be suspected in any patient with neuropathy who presents with a swollen, warm, erythematous foot.
Patients should be referred to the on call orthopaedic team (Page 3000).