Charcot Foot

Question 1

Charcoat Foot

Answer 1

• chronic progressive loss of protective sensation
• leads to joints and bony structures

*midtarsal > MTP > subtalar > ankle joint

Question 2

Etiology

Answer 2

DM

Question 3

Pathology

Answer 3

1. Neurotraumatic: repetetive microtrauma

2. Neurovascular: inflammatory cytokines cam abnormal resorption, formation (AV shunting?)

Question 4

Clinical Features

Answer 4

Acute

• inflammation
• foot lifting relieves redness

Chronic
-?

Question 5

Eichenholtz classification

Answer 5

Based on clinical features and radio findings

Stage 0: Acute
Stage 1: Fragmentation
Stage 2: Coalescence
Stage 3: Reconstruction

Question 6

Imaging

Answer 6

1. X-ray:
   - dense bones (sclerosis)
   - bone destruction
   - joint dislocation and fragmentation
2. Bone scan
   3.

Question 7

Treatment

Answer 7

1. Non-operative (first line)
   - total contact cast, TCC (2-4 months)
   - Charcoat restraint orthotic walker (CROW)
   - Shoe modification
   - biphosphate (inhibit bone resorption)
2. Operative (Stage 3)
   - exostectomy
   - arthrodesis
   - amputation