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Asymptomatic Charcot foot in longstanding diabetes
1CABS, F.I.B.M.S., General Surgery Board, Surgical Department, Faculty of Medicine, Al-Anbar University, Al-Ramadi City, Iraq.
Surgery in Practice and Science
|July 26, 2026
Summary
Plain X-rays detected early Charcot osteoarthropathy in over half of diabetic patients, highlighting the need for MRI confirmation. Early detection aids in preventing foot deformity and managing diabetic foot complications.
Area of Science:
- Diabetology
- Radiology
- Orthopedics
Background:
- Charcot neuropathic osteoarthropathy affects 0.1-7.5% of diabetic patients, often misdiagnosed due to subtle early symptoms.
- High rates of undiagnosed cases (0.4-13%) underscore the need for improved detection methods.
Purpose of the Study:
- To evaluate plain X-ray efficacy in detecting preclinical Charcot disease in patients with long-standing type 2 diabetes mellitus.
- To identify early radiographic signs of Charcot osteoarthropathy before clinical deformity develops.
Main Methods:
- A cross-sectional study of 60 adults with type 2 diabetes mellitus (>10 years duration) was conducted.
- Bilateral foot X-rays, clinical/neurological assessments, and HbA1c levels were obtained.
- Short-term follow-up included X-ray and MRI for positive cases.
Main Results:
- Over half (51.7%) of patients showed X-ray changes consistent with Charcot patterns.
- X-ray positivity correlated with older age, longer diabetes duration, higher HbA1c, and increased BMI.
- At 6 months, 19.4% of positive cases showed radiological progression, prompting MRI and offloading.
Conclusions:
- Plain foot X-rays revealed Charcot patterns in a significant proportion of diabetic patients, suggesting potential for early detection.
- Further MRI-validated studies are needed to confirm these radiographic findings before widespread screening.
- Glycemic control and patient education on trauma prevention remain crucial for managing diabetic foot complications.
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