DIABETES & CHARCOT: WHAT IS CHARCOT?

If you have Diabetes or know someone who has Diabetes, this will be an important article for you to read. Charcot Deformity pronounced “Sharko” is condition that today is most prevalent in people who have Diabetes Mellitus as well as people with Neuropathy; Diabetes and Neuropathy are commonly related.

Typically, a Charcot foot appears to be red, hot and swollen. Charcot is a condition that causes softening and subsequent fractures of the bones in the foot due to a sudden trauma or constant repetitive micro trauma.

Usually a person with Diabetes who also has Neuropathy, or a loss of sensation in the foot, will not notice the Charcot until it starts affecting their daily routine. The Diabetic patient will start to notice that they are not able to fit into their shoes any longer, or they may notice an ulcer that has developed on the bottom of their foot for no apparent reason. By this time however, the

Charcot has already progressed significantly.
The best treatment for Charcot is prevention and early diagnosis and treatment.
Once the neuropathic patient gets a fracture, the body’s normal response is to increase the blood flow to the area to help to heal the affected bone. This increase in blood flow tends to wash out the calcium from the bone at the fracture point. This weakens the bone and the bone fractures even further and collapses. Due to the neuropathy or lack of sensation, the patient is unable to sense the fractures and the bone continues to go through the cycle of fracture and collapse.
The most common areas to be affected are the midfoot as well as the ankle.

PREVENTION: WHAT YOU SHOULD LOOK FOR
As I said earlier, the best treatment for Charcot is prevention and early diagnosis. In order to prevent Charcot Foot/Ankle, the Neuropathic patient, typically with Diabetes should adhere to strict guidelines, including:

1. Blood Sugar: Blood sugar should be monitored daily and kept under control.
2. You should have regular checkups with your Podiatrist. X-rays taken periodically is helpful in diagnosing Charcot early.
3. Make sure you check your feet daily, and if you notice signs, such as redness, swelling, and increase in temperature of the foot (a foot that feels warm or hot to the touch) contact your Podiatrist immediately.

Charcot deformity goes through several stages: Stage 0: This is when there are no signs of Charcot on X-ray, but there are some clinical signs such as redness and swelling.

Stage 1: This stage is due to trauma (sudden or micro trauma) to the foot and the bone starts to breakdown.
Stage 2: The bone begins to heal and there is increased blood flow to the area.Stage 3: The final stage is when the stable bone starts to form again.

Once Diagnosed, the Treatment includes:
1. Immobilization: complete non-weight bearing of the foot afflicted with Charcot is necessary. The patient must use crutches or a wheelchair. This may take months or even longer until the Charcot can heal.
2. Custom made shoes and Reduction in activity may be necessary after the deformity and the bone have healed. The custom shoes may aid in a more normal return to walking. The chances of a person developing Charcot on the opposite foot increases if they have had Charcot in one of the feet.
3. Finally, depending on the severity of the deformity, surgery may be required in some cases.
If you do notice any of these signs and symptoms of Charcot, as mentioned above; redness, swelling and an increase in temperature of the foot, Contact your Podiatrist Immediately.

This could indicate a very serious condition. If Charcot is not diagnosed and treated early, it could lead to a very serious deformity of the foot. In some cases surgery or even amputation may be necessary. Prevention and Early diagnosis of Charcot is Key.