John Nebitt M.D.
The Charcot Foot
  • A Charcot foot in either its acute inflammatory or chronic bony deformity stage requires follow up by a skilled foot care specialist or orthopedic surgeon.
  • Patients with an acute Charcot foot often present with a red, warm foot with pounding pulses, and frequently give a history of minor injury to their foot or ankle a few days before. Despite the foot's horrific appearance, the patient may only report minor discomfort. Conversely, the patient may be surprised how painful their previously insensate foot is. Because an acute Charcot foot clinically mimics cellulitis, an infective process must first be ruled out.
  • It must be emphasized that, in the acute Charcot foot, there often are no x-ray abnormalities for 2-3 weeks indicating an ongoing destructive bone process. But if the patient is allowed to continue to walk on the foot, within weeks the joint complex in the middle of the foot can collapse, and the foot will start to take a rocker bottom configuration. For further information regarding Charcot feet, we have supplied the following link.
Charcot Foot   Charcot Foot
The acute presentation of a Charcot Foot

  The radiograph changes seen with a Charcot Foot

Charcot Foot   Charcot Foot
Total contact casting is the treatment of choice for an acute Charcot foot   Two examples of chronic Charcot feet after the inflammation stage has resolved. Now clam-shell braces or custom boots can be put into place
© COPYRIGHT 2008 JOHN NESBITT M.D.