Charcot arthropathy is commonly associated with diabetes. But diabetes only represents one of many ways in which the normal sensation to the foot is disrupted. This disruption of normal sensation is called peripheral neuropathy (PN). Other common contributing factors to PN include lumbar radiculopathy (lumbar pain), lumbar surgery, alcohol abuse or chemotherapy. PN diminishes the ability to feel pain. As a result of this loss of sensation, patients undergo micro-fractures that propagates within the the bone adjacent to the joints of the midfoot or ankle.
What’s the standard of care for Charcot arthropathy? In newly diagnosed cases, the standard of care is prompt off-loading of the foot. The diagnosis of Charcot arthropathy does require a high degree of suspicion on the part of the physician and is an often overlooked diagnosis.
But what about long term management of Charcot arthropathy? That’s where the standard of care is poorly defined. Will reconstructive surgery help? When is amputation indicated?
I think we have a lot to learn about the long term management of Charcot arthropathy. But most importantly, the bottom line is to prevent the onset of PN in the first place.
Jeffrey Oster, DPM
Medical Director
Myfootshop.com
