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Definition

What is Charcot joint?

Charcot’s joint is a disease occurring when diabetic nerve damage causes a joint to break down. It is also called neuropathic arthropathy, this condition is seen in the feet and ankles in people with diabetes. Nerve damage in the feet is common in diabetes, which may lead to Charcot’s joint. A loss of nerve function leads to numbness. People who walk on numb feet are more likely to twist and injure ligaments without knowing it. This places pressure on the joints, which can eventually cause them to wear down. Severe damage leads to deformities in the foot and other affected joints.

How common is Charcot joint?

Charcot joint is prevalent in 0.8 to 7.5 percent of diabetic patients with neuropathy; 9 to 35 percent of these affected patients have bilateral involvement. The higher prevalences occur in referral-based practices. Most patients with Charcot joint have had poorly controlled diabetes mellitus for 15 to 20 years.

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Charcot joint?

Depending on the stage of the disease, the clinical presentation varies from mild swelling to severe swelling and moderate deformity. Inflammation, erythema, pain and increased skin temperature (3–7 degrees Celsius) around the joint may be noticeable on examination. X-rays may reveal bone resorption and degenerative changes in the joint. These findings in the presence of intact skin and loss of protective sensation are pathognomonic of acute Charcot arthropathy. Roughly 75% of patients experience pain, but it is less than what would be expected based on the severity of the clinical and radiographic findings.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Charcot joint?

There are two theories (neurotraumatic and neurovascular) explain the pathogenesis of Charcot foot. The neurotraumatic theory attributes bony destruction to the loss of pain sensation and proprioception combined with repetitive and mechanical trauma to the foot. The neurovascular theory suggests that joint destruction is secondary to an autonomically stimulated vascular reflex that causes hyperemia and periarticular osteopenia with contributory trauma. Intrinsic muscle imbalance with increased heel and plantar forces can produce eccentric loading of the foot, propagating microfractures, ligament laxity and progression to bony destruction.

Risk factors

What increases my risk for Charcot joint?

You may have higher risks for this condition if you are experiencing the diabetes. Thus the risks of Charcot joint are also the same as the diabetes. They may include:

Weight

The more fatty tissue you have, the more resistant your cells become to insulin.

Inactivity

The less active you are, the greater your risk is. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.

Age

Your risk increases as you get older. This may be because you tend to exercise less, lose muscle mass and gain weight as you age.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Charcot joint diagnosed?

Clinical findings include erythema, edema and increased temperature in the affected joint. In neuropathic foot joints, plantar ulcers may be present. Note that it is often difficult to differentiate osteomyelitis from a Charcot joint, as they may have similar tagged WBC scan and MRI features (joint destruction, dislocation, edema). Definitive diagnosis may require bone or synovial biopsy.

How is Charcot joint treated?

Most cases of acute Charcot foot can be treated nonsurgically with pressure-relieving methods such as total contact casting (TCC), which is believed to be the gold standard of treatment. TCC was developed in the 1950s. Most of the cast padding is eliminated for exact conformity to the lower extremity, with the goal of evenly distributing forces across the plantar surface of the foot. A tubular stockinette with low-density foam or one-quarter inch felt is applied over the tibial crest and malleoli, and around the metarsal heads with one layer of padding.

Patients with a consolidated (stable chronic) Charcot foot with a residual exostosis or recurrent or nonhealing ulcer may require an exostosectomy. In patients whose subluxation produces a markedly unstable extremity, a joint stabilization procedure performed by a foot and ankle specialist may be required.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Charcot joint?

The following lifestyles and home remedies might help you cope with Charcot joint:

Make a commitment to managing your diabetes

Learn all you can about diabetes. Establish a relationship with a diabetes educator, and ask your diabetes treatment team for help when you need it.

Choose healthy foods and maintain a healthy weight

Losing just 7 percent of your body weight if you’re overweight can make a significant difference in your blood sugar control. A healthy diet is one with plenty of fruits, vegetables, whole grains and legumes, with a limited amount of saturated fat.

Make physical activity part of your daily routine

Regular exercise can help prevent prediabetes and type 2 diabetes, and it can help those who already have diabetes to maintain better blood sugar control.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 14, 2017 | Last Modified: August 14, 2017

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