Charcot foot

Charcot foot is a condition that affects the bones and joints of the foot or ankle, most often in people with diabetes or peripheral neuropathy, a form of nerve damage in the feet. Because early stages may cause little or no pain, minor injuries can go unnoticed and worsen over time. Early evaluation and ongoing care help protect the foot and support safe movement for the long term.

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Medical illustration of foot anatomy showing muscles, ligaments, tendons and bones.

Anatomy of the foot and ankle

Your foot has many small bones and joints that work together to support your weight and allow you to walk. Healthy nerves help you feel pain, pressure and temperature, so your body can respond quickly to injury.

Peripheral neuropathy reduces these warning signals. When your foot can't feel pain or pressure the way it should, small injuries can go unnoticed and continue to worsen, putting the bones and joints of the foot and ankle at risk.

Overview

Symptoms

You may be developing Charcot changes in your foot or ankle if you notice:

Redness, warmth and significant swelling in one foot compared with the other
A foot that feels hot to the touch but may not be very painful
Changes in foot shape, arch height or ankle alignment
Instability or difficulty fitting into your usual shoes
Thickened skin or areas of increased pressure on the sole of the foot
In later stages, calluses, ulcers or wounds that heal slowly

Symptoms may develop gradually or appear after a minor injury or sprain you may not recall clearly.

Causes

Charcot foot can develop when one or more of the following put stress on your foot:

Longstanding diabetes with peripheral neuropathy
Loss of protective sensation, or a reduced ability to feel pain or pressure
Poor circulation or vascular disease
Kidney disease or other conditions that weaken bone
Repetitive stress from walking on an injured foot
Prior foot surgery or broken bones that change how your foot moves

Risk factors

Certain factors can raise your risk of developing Charcot foot, including longstanding diabetes, peripheral neuropathy, poor circulation and kidney disease. Having one or more of these risk factors doesn't mean you'll develop Charcot foot. It simply means it's worth talking with your care team about how to protect your feet and catch any changes early.

Diagnosis

Your foot and ankle specialist will review your medical history, including diabetes control, neuropathy and any prior foot problems. Your evaluation may include a physical exam to check for swelling, warmth, deformity and skin changes, along with a comparison of both feet for temperature, shape and range of motion. X-rays help look for fractures, joint changes or collapse, and advanced imaging such as MRI or CT may be used when early changes are suspected, but X-rays appear normal. Vascular and nerve testing may also be done to evaluate circulation and sensation.

During your visit, we take the time to explain what we see on imaging, discuss the stage of Charcot changes and outline next steps to protect your foot.

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We offer leading-edge treatments for most foot and ankle conditions, treating many with medications, bracing and injections.

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Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.