Charcot Joint Disease - Causes and Treatment Options
Charcot Joint Disease, or neurogenic osteoarthropathy, is a serious condition that affects the foot and ankle in patients with peripheral neuropathy, most often found in diabetics. The condition occurs from abnormal blood flow associated with impaired sensation in the foot. If left untreated, these physiological abnormalities result in severe destruction and literal crumbling of the bones and joints of the Foot and Ankle. Up to 2.5% of patients with diabetes will develop Charcot foot.
Charcot Foot Symptoms
Initial signs and symptoms of Charcot foot include extreme swelling and redness of the affected foot and ankle. There may be pain associated with Charcot foot but often the condition is painless due to underlying neuropathy. While there is often no identifiable event leading to this condition, simple trauma such as an ankle sprain or stubbing a toe may set off the development of a Charcot joint. Therefore, it is extremely important that any patient with peripheral neuropathy to immediately visit a board certified foot and ankle specialist should they notice any redness or swelling in their foot and ankle, or should they undergo any minor trauma to the foot and ankle.
Diagnosing Charcot Foot
Clinicians who do not specialize in the treatment of diabetic feet will often misdiagnose this as infection, which results in improper treatment and poor outcomes. Early diagnosis is paramount to the successful treatment of a Charcot joint. X-rays may demonstrate early joint subluxation, fragmentation or fractures. An MRI may also be suggested, as it is more sensitive to showing extensive edema throughout the bones neighboring the affected joints.
Charcot Foot Treatment
Treatment of acute Charcot foot consists of Immobilization and non weight-bearing. The condition should then progress through the later stages of the disease, coalescence and remodeling. If significant deformity has not developed, the patient may avoid surgery through the use of custom supportive bracing and footwear.
However, if a significant collapse of the foot or ankle has occurred, reconstructive surgery may be indicated. Otherwise, wounds may easily develop which could result in deep infection and often lead to amputation.
Charcot Foot Surgery
The type of surgery indicated depends on the stability and alignment of the foot and ankle. If the foot is stable, but simply demonstrates a prominence, a planing procedure may be performed where the sharp bone is simply removed. However, if the foot is malaligned or unstable and not conducive to bracing, fusions and osteotomies will be indicated by the surgeon. This is a highly sub-specialized area of foot and ankle surgery and should only be performed by surgeons who are experienced in this field. Board certification in reconstructive rear foot and ankle surgery by the American board of foot and ankle surgeons is of utmost importance. The procedures require extensive internal and often external fixation in order to result in a lasting stable and well-aligned foot, and thereby attempt to avoid amputation. However, despite best efforts and excellent technical skills, Charcot patients often end up with amputations nonetheless.
Make Your Appointment with our Specialized Surgeons Today!
Several surgeons at certified Foot & Ankle specialists specialize in this type of surgery and are listed below. If you or someone you know suffers from advanced peripheral neuropathy, it would behoove you to develop a relationship with these doctors sooner than later so that they are familiar with your overall health status prior to the development of such an issue. Certainly, if you have shown signs or symptoms or been diagnosed with Charcot foot, you should schedule an appointment with Dr. Kyle Kinmon, Dr. Ashley Bowles or Dr. Julio Ortiz of these doctors immediately. 1-855-550-FEET