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Diabetics with Neuropathy: Know The Signs of Charcot Foot

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Although Charcot foot is an unpleasant topic, ignorance of this condition can lead to foot deformities and permanent mobility impairment. Charcot arthropathy, or Charcot foot, is the dislocation or fracture of bones and joints - with little or no known trauma - that may develop in individuals with diabetic neuropathy. The fractures and dislocations may be owed to frequent micro traumas that exceed the bones’ ability to heal. Circulation changes might also trigger the loss of bone minerals, leaving bones weak and susceptible to fracture and displacement.

Why Delayed Diagnosis

Because there is often a delay between the onset of Charcot foot and a diagnosis, those with or at risk of neuropathy should know the signs of this serious condition. Delays in diagnosing Charcot foot may be owed to:

  • The symptoms, which are non-specific, are also signs of infection or arthritic conditions.
  • People with neuropathy may lose sensation in their feet and not feel the pain of fractured or dislocated bones.
  • People with neuropathy may be used to experiencing foot pain and not realize something else is going on.
  • The illness may not be immediately recognized by doctors who do not specialize in foot and ankle issues.

The reasons for diagnosis delay make it clear why individuals with neuropathy need to be on the look out for Charcot foot symptoms, and have them checked.

Redness, Swelling, Warmth

Initial signs of Charcot foot (or ankle) are usually redness, swelling, and increased warmth in the affected area or areas (e.g., midfoot, hindfoot, ankle, heel, and forefoot). Early detection and the use of supportive, protective, or corrective shoes or orthoses can prevent or minimize permanent injury. Untreated injury can lead to deformities such as the collapse of the midfoot arch (known as “rocker bottom foot”), or ankle and hindfoot instability. Those who see their physician with symptoms of neuropathy, redness, swelling, and warmth usually undergo periodic radiographs to determine whether there is soft tissue inflammation, and any bone or joint displacement.

Treatment, Recovery

If fractures are discovered, non-surgical treatments include walking braces, protective splints, orthotics, or wearing a cast. Putting weight on the affected foot may be limited. Surgical options include realignment and fusion of bones, and removing problematic bony prominences. Healing can take several months and may be especially slow after surgery. Many patients will continue to use supportive, protective gear after recovery. Some individuals must limit standing or walking to what is essential for daily living. So, see your doctor soon as possible for redness, swelling, and warmth - with or without pain - in limbs affected by neuropathy.

Source: AOFAS / Photo credit: Kai Schreiber

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