Charcot Neuroarthropathy: A case study of Foot Presentation and Management

Abstract

Charcot neuroarthropathy (CN), also referred to as Charcot arthropathy represents a rare yet critical complication of diabetic peripheral neuropathy. Misdiagnosis or inadequate treatment of this condition can lead to severe consequences, including the need for major amputations and loss of limb functionality. While the precise pathogenesis of Charcot arthropathy remains elusive, two prevailing theories have been proposed. The neurotraumatic theory and neurovascular theory. Clinical presentation typically involves unilateral swelling, erythema, and localized warmth to the foot, often progressing to a “rocker bottom” deformity over time. We present a case of a 45-year-old male with long-standing type 1 diabetes mellitus (T1DM) who presented with a painless, swollen, and warm right foot, initially misdiagnosed as a diabetic foot infection. Further examination revealed a collapse of the longitudinal arch and a clinical diagnosis of Charcot’s neuroarthropathy was established. Imaging studies confirmed destructive changes consistent with Charcot neuropathy, leading to subsequent management with total contact casts and referral for reconstructive surgery. Prompt detection and appropriate treatment are imperative given the potential ramifications of Charcot foot, with current management strategies emphasizing prolonged immobilization and physical off-loading.

How to cite this: Zaheer Uddin, Bashir I. Charcot Neuroarthropathy: A case study of Foot Presentation and Management. JPES. 2024;1(1):37-40.