Charcot Foot (Charcot Neuroarthropathy)

Charcot foot (Charcot neuroarthropathy) is damage to the bones and joints of the foot in people who have lost protective feeling, most often from diabetes nerve damage.^1,2 The foot becomes warm, swollen and red, and pain may be absent or relatively mild because the nerves no longer report it properly.¹ Because it looks so much like an infection or an injury, it is commonly missed, and Australian general practice reporting describes it being mistaken for bone infection and cellulitis.³ While the bones are soft, every step can flatten the arch and change the shape of the foot for good.

The treatment is offloading, which means taking the weight off the foot and holding it still. International guidance says to start knee high immobilisation promptly while further tests are arranged, using a non removable knee high device, preferably a total contact cast.¹ PDC does not apply total contact casts or non removable knee high devices. Australian guidance lists a unilateral red, hot, swollen foot as a reason for immediate referral to a multidisciplinary foot care clinic, so our job is to recognise it, document it and get you to a high risk foot service at a tertiary hospital.²

Remission takes time, and international guidance notes it can be many months before the condition settles.¹ After that, the work shifts to protecting a foot whose shape has changed: footwear and insoles that fit it, and foot checks at an interval set by your risk level, which runs from yearly at very low risk to every one to three months at high risk.^2,4 Our podiatrists measure circulation, provide skin and nail care and prescribe inserts for your shoes.⁵ You do not need a referral to book with them. Diagnosis, imaging and medicines stay with your GP or specialist.