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Joint disease related to diabetic nerve damage - Charcot

Nerve damage in the foot can cause a rare but serious joint disease which requires you to wear a cast and special footwear for a long time.

The image shows Charcot at the backside of left foot, The normal structure of the foot has spread and collapsed. image: HUS Podiatry
Charcot at the backside of left foot, image: HUS Podiatry

Charcot foot is a relatively rare condition related to diabetic nerve damage which affects the joints of the foot. Similar joint changes may also be present in some other diseases of the nervous system.

Predisposing factors for Charcot

The underlying factors of Charcot disease include a loss of sensation in the foot arising from diabetic sensory nerve damage and changes to blood circulation in the foot due to damage to the autonomic nervous system. Often, the trigger factor is a seemingly innocent injury, twisting your ankle, a wound, operation or infection. As a result, the increased activity of the cells that break down bone will gradually lead to the bones and joints of the foot becoming fragile and starting to break or dislocate.

Symptoms and diagnosis

The symptoms of the acute stage include swelling, redness and gleam in the foot. It is easy to mistake for erysipelas or a gout infection. As a result of the changes in the bones, the shape of the foot changes. Normally, there is no pain in the foot. The earlier Charcot disease is diagnosed and treated, the better the result.

Normally, diagnosing Charcot disease requires an X-ray or MRI scan and blood tests.


The treatment is placing the foot in rest. In a suspected case of Charcot, not weight should be put on the foot and crutches should be used. After the diagnosis, person is required to wear a cast for a long time, normally 6 months to a year.

Because of the posture fault resulting from the joint changes caused by Charcot disease as well as the loss of sensation in the foot, there is a high risk of ulceration. To prevent it, person should wear orthopaedic inserts and footwear to reduce the strain on the foot.

Updated 8.11.2023