Charcot Neuroarthropathy, also known as Charcot foot and ankle, is a syndrome in patients who have neuropathy. It includes fractures and dislocations of bones and joints that occur with minimal or no known trauma. Initially, there may be swelling, redness and increased warmth of the foot and ankle. Later, when fractures and dislocations occur, there may be severe deformities of the foot and ankle, including collapse of the mid-foot arch (often called rocker bottom foot) or instability of the ankle and hind-foot. The syndrome progresses through three general stages:
- Stage 1 (acute, development-fragmentation): marked redness, swelling, warmth; early radiographs show soft tissue swelling, and bony fragmentation and joint dislocation may be noted several weeks after onset;
- Stage 2 (subacute, coalescence): decreased redness, swelling and warmth; radiographs show early bony healing;
- Stage 3 (chronic, reconstruction-consolidation): redness, swelling, warmth resolved; bony healing or nonunion and residual deformity are frequently present.
Charcot foot occurs in patients with peripheral neuropathy resulting from diverse conditions including diabetes mellitus. Repetitive micro trauma that exceeds the rate of healing may cause fractures and dislocations. Changes in circulation may cause resorption of bone , weakening the bone and increasing susceptibility to fracture and dislocation.