A recent article just came out that shows there is an increase in the occurrence of "charcot foot." This condition usually affects diabetic patients who have decreased sensation or "neuropathy." The process is not completely understood, but essentially the foot starts breaking in the midfoot. What are supposed to be hard bones can become like mush. The condition is self limiting and eventually the bone destruction stops. The bones then will heal. The problem is not the process causing damage it is when the patient walks on this foot that is breaking. It can deform the foot and the bones can heal leaving a "rocker bottom" foot that is difficult to walk on. This can cause sores, or "ulcers." These ulcers can become infected and patients can have to have an eventual amputation from the problems this condition can cause.
The key to treating "charcot foot" is prevention. A diabetic patient that usually doesn't have foot pain should be seen as soon as possible as this could be the early start of the condition. The condition is often misdiagnosed as an infection or gout as the foot can become red and swollen mimicking these conditions.
If caught early, strict immobilization is imperative. If caught after the deformity has already lead to disfigurement of the foot, wounds often develop and special braces and offloading shoes are needed. This often becomes a wound care center issue.
I am not writing this to scare people but instead educate them. This condition is rare but is becoming more common as I am seeing in my practice. The take home message is to go see your podiatrist as soon as possible if you have any foot pain, especially if you are a diabetic.
