Diabetic Charcot Foot

Abstract

Charcot arthropathy is a progressive condition of the musculoskeletal system closely related to diabetes. It is characterized by joint dislocations, pathologic fractures and debilitating deformities resulting in progressive destruction of bone and soft tissues at weight-bearing joints. In extreme and severe cases the disease may cause significant disruption of the bony architecture. The most common aetiology theory considers that Charcot arthropathy is caused by an unperceived trauma or injury to an insensate foot. The sensory neuropathy renders the patient unaware of the osseous destruction that occurs with ambulation and thus this microtrauma leads to progressive destruction and damage to bone and joints. Charcot arthropathy can occur at any joint; however, it occurs most commonly in the lower extremity, at the foot and ankle. Several classification systems based on clinical, radiographic, and anatomic pathology describe Charcot arthropathy. Anatomic classification systems are the most commonly used and have the added benefit of predicting outcome and prognosis. The most commonly used anatomic system is described by Saunders and Mrdjencovich. Based on the location of the arthropathy, their system classifies Charcot arthropathy into five different patterns: