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The Charcot foot.

W Jeffcoate1, J Lima, L Nobrega

  • 1Department of Diabetes and Endocrinology, City Hospital, Nottingham, UK. jeffcoate@bigfoot.com

Diabetic Medicine : a Journal of the British Diabetic Association
|May 23, 2000
PubMed
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Charcot foot in diabetes mellitus is a common, yet often unrecognized, condition. Early identification is crucial to prevent severe deformity, with neuropathy and abnormal blood flow playing key roles in its development and resolution.

Area of Science:

  • Diabetology
  • Neurology
  • Orthopedics

Background:

  • Charcot foot is a serious complication of diabetes mellitus.
  • It is characterized by progressive bone and joint destruction, often leading to severe deformity.
  • Early recognition and intervention are critical to prevent irreversible damage.

Purpose of the Study:

  • To review the clinical manifestations of Charcot foot in diabetes mellitus.
  • To explore the underlying theories concerning its aetiology.
  • To highlight the importance of early diagnosis and management.

Main Methods:

  • Systematic review of published literature.
  • Searched Medline using keywords: 'Charcot', 'foot', 'diabetes', and 'neuropathy'.
  • Examined references from recent review articles.

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Main Results:

  • Charcot foot is common but often unrecognized by non-specialists.
  • Severe peripheral neuropathy is a prerequisite for developing Charcot foot.
  • The condition involves motor neuropathy, osteopenia, and reduced pain sensation, leading to foot deformity.

Conclusions:

  • Failure to identify Charcot foot early leads to significant deformity due to continued weight-bearing.
  • Increased bone blood flow, possibly due to loss of sympathetic innervation, is implicated.
  • An abnormal vasomotor reflex, similar to reflex sympathetic dystrophy, may contribute to the pathogenesis and self-limiting resolution of the condition.