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Wound Care: Charcot Foot

Updated: Sep 28


Charcot neuroarthropathy is a rare, but serious, disabling condition which can cause widespread destruction of bone and joint architecture with loss of function. Charcot neuroarthropathy is commonly referred to as a Charcot foot. This condition is often misdiagnosed early in its presentation because of a lack of knowledge among members of the medical community. Consequently, initial therapies for this condition are fewer and patients who present in more advanced stages of the condition are more difficult to manage. Charcot neuroarthropathy is a multifactorial process resulting in unregulated osteoclastogenesis and bony destruction. Classically, when these patients present to a wound care center, the patient has an edematous, erythematous foot with increased temperature. These non-specific findings lead to a multitude of differential diagnoses, with many mistakenly treated for cellulitis or osteomyelitis in centers. Podiatrist need to be part of every multidisciplinary wound care team. Below is an algorithm that summarizes the best available evidence for management of Charcot Neuropathic Osteoarthropathy (CN), commonly referred to as the Charcot Foot.

References:

1. Marmolejo, V. S., Arnold, J. F., Ponticello, M., & Anderson, C. A. (2018). Charcot foot: clinical clues, diagnostic strategies, and treatment principles. American family physician, 97(9), 594-599.

2. Schmidt, B. M. (2020). Clinical insights into Charcot foot. Best Practice & Research Clinical Rheumatology, 101563.

3. Schmidt, B. M., & Holmes, C. M. (2019). Influence of patient setting and dedicated limb salvage efforts on outcomes in Charcot-related foot ulcer. The international journal of lower extremity wounds, 18(4), 362-366.

4. Trieb, K. (2016). The Charcot foot: pathophysiology, diagnosis and classification. The bone & joint journal, 98(9), 1155-1159.

5. Yousaf, S., Dawe, E. J., Saleh, A., Gill, I. R., & Wee, A. (2018). The acute Charcot foot in diabetics: diagnosis and management. EFORT open reviews, 3(10), 568-573.

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