Warm, Swollen And Painful Foot That Feels Like It’s Collapsing?
Every once in a while, we come across a less common but very serious foot condition at just the right time. Today, we thought we’d share one that could have easily been missed, but where we as podiatrists could make a real difference to the well-being of a patient through early detection.
Jim came in to see us for his 12-month orthotic check one morning. We’d treated him for heel pain the year prior. When discussing how his feet had been since we’d seen him last and assessing the wear and compression on his orthotics, he said one of his feet had been uncomfortable and red over the last couple of days. When we looked at his foot, it appeared swollen, red and warm to touch.
Chatting further to Jim about his medical conditions, he mentioned some circulation issues and that he knew the feeling in his feet wasn’t what it used to be. It’s at this point that it clicked.
Charcot foot, otherwise known as Charcot arthropathy, describes the weakening of the bones and joints of the feet, making them vulnerable to fracturing and dislocating. This ultimately leads to the collapse of the foot, leading to a rocker-bottom shaped deformity particularly around the midfoot.
Charcot foot occurs in people with some kind of neuropathy or nerve damage, which is often related to diabetes, but may also be linked to alcoholism and other causes. Sometimes it’s difficult to pinpoint what triggers the problem to start, as neuropathy can make it difficult to feel any changes. Fractures and sprains in the foot that are not effectively managed can also create the right conditions that trigger the chain of events that lead to Charcot foot.
According to studies, the average age of patients with arthropathy is around 50 years, with only a small percentage of those affected aged below 34 . In the majority of cases only one food is affected.
“Causes of, or underlying problems, behind charcot arthropathy, aside from type 1 and 2 diabetes, may involve traumatic injuries (spinal cord injuries, peripheral nerve injuries), infections (syphilis, leprosy, yaws), disorders of neurological structures (myelomeningocele, syringomyelia, spina bifida), neurodegenerative diseases (amyloid neuropathy, neuropathies secondary to alcoholism and vitamin deficiency) and other neurological disorders such as congenital insensitivity to pain syndrome, steroid intake (post-renal transplant arthropathy, intra-articular steroid injections), and heavy-metal poisoning.”
Early Detection Is Key
As soon as the possibility came up that Jim may be in the early stages of a Charcot foot collapse, we immediately got in contact with his GP and referred him for some medical imaging to confirm the presence of the condition.
When it is detected early, the right measures are able to be taken to control the problem as much as possible, including relieving damaging pressure from the foot and keeping it supported in a moon boot to help prevent or limit the rocker-bottom deformity that can significantly affect a person’s quality of life.
Jim’s results confirmed Charcot foot and he was able to get the right care to get the best outcomes for his foot, which will help him stay as mobile as possible for many years to come instead of suffering significant restrictions to his mobility. For us, this is a great example of why it’s important to seek help early when pains, niggles or other issues arise with your feet - especially when you have conditions like diabetes, impaired healing, problems with your circulation or other issues that may put your foot health at risk.
Need help with your feet?
If you have any concerns with your feet, our experienced podiatry team would love to help. We combine world-class facilities and services with a caring and passionate team that looks at the bigger picture to help you optimise your health, so you can realise your full potential.