Charcot foot

Case contributed by Dr Domenico Nicoletti


Metatarsal deformation without trauma or pain on a background of poorly-controlled diabetes.

Patient Data

Age: 65 years
Gender: Male

Lateral foot radiograph demonstrating complete loss of the arch due to bony fragmentation and dislocation of the midfoot with a reduced calcaneal inclination angle.

There is a fracture of the second metatarsal base with new bone apposition and osteophytic beaks.

There is also partial destruction of the cuboid and of all the cuneiforms with marked pes planus along with sclerosis at the tarsometatarsal joints.

Case Discussion

Charcot foot develops in patients who have reduced sensation in their feet secondary to peripheral neuropathy. 

Downward collapse of the tarsal bones leads to convexity of the sole and is referred to as a “rocker foot”. Large osteophytes may protrude from the top of the foot.

Neuropathic arthropathy is either atrophic or hypertrophic.The atrophic form is usually localized to the forefoot and causes osteolysis of the distal metatarsals while the hypertrophic type usually occurs at the midfoot, hindfoot or ankle.

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