Charcot foot: Presentation

Abstract

Charcot neuropathic osteoarthropathy (CN) or Charcot foot is one of the most challenging foot complications in diabetes. It is characterised by varying degrees of bone and joint disorganisation, secondary to underlying peripheral neuropathy and trauma leading to fracture, bone fragmentation and ultimately foot deformity. The latter can be further complicated by ulceration, which can become infected and if not promptly managed it can lead to an amputation. The Charcot foot occurs in both type 1 and type 2 diabetes. Patients with type 1 diabetes and Charcot foot are significantly younger and have longer duration of diabetes compared with patients with type 2 diabetes. More recently, CN has been linked with prediabetes. An improved global recognition of CN in diabetes is acknowledged. A series of reports, published from various parts of the world, have described typical contributing factors to CN together with some region-specific features. This chapter discusses the incidence and prevalence of Charcot foot in diabetes. It also summarises the impact of common risk factors including impaired glycaemic control, diabetic neuropathy, trauma, foot ulceration and simultaneous pancreas and kidney transplantation. Delineation of causes more commonly associated with the development of CN in type 1 or type 2 diabetes is made. Improved awareness of the current presentation of the Charcot foot in diabetes is key to recognise the condition early, institute timely management and prevent adverse outcomes.