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What is Charcot’s Disease of the foot Joints ? Podiatry FAQ : 99

by Stephanie on September 25, 2010

Dislocated Talus bone protrudes from the arch

Charcot’s disease of joints is a degenerative disease that causes the destruction of the bones and joints within the foot. Initially, the foot will appear completely normal. As it develops, the foot may have significant amounts of soft tissue swelling and color changes. It may then become hot and swollen but not painful.
The most common outcome is that the talus bone (under the ankle) becomes dislocated and no longer sits in a horizontal position.  It slips out of it’s socket and drops down at the front, protruding toward the ground from the arch of the foot. While the decay that sets up this dislocation is progressive, the dislocation will occur in a single step.  Other possible results include rampant spurring of joint surfaces, loss of bone strength, other dislocations, fractures and fragmenting bones.  Due to the neurological nature of the condition, it is not painful.

Charcot’s disease results from nerve disorders particularly diabetic neuropathy but also including leprosy, alcoholic neuropathy, syringomyelia, or other conditions that compromise the spinal cord. The condition is characterized by hypermobility and instability of the joint.

Charcot’s disease comes about because of the loss of pain sensation which robs your body of the automatic protection afforded by steering clear of painful actions. A good way to think of how it happens is this.  Imagine that you went to the gym and used a heavy hand weight to do arm curls.  If, instead of using it properly, you flung it out to the full extent that your elbow could straighten to, over and over again, it would start to hurt.  Throw in the absence of sensation inside the joint and your body will let you do this with each and every step. That is how Charcot’s disease comes to destroy a joint.

Charcot’s Disease can be interrupted before damage occurs.  Firstly, if you have diabetes, see a podiatrist and find out if you have neuropathy.  People who do will often not know. If the podiatrist finds that your sensation is diminished, you should wear orthotics to stop your joints to be able to move to the ends of their ranges of motion while you walk. Protecting your feet this way will go a long way to deferring the onset of destructive joint forces.

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