Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Charcot joint is a destructive process that primarily affects joints in the weight-bearing extremities, such as the feet, ankles, knees, and possibly hips. Many times a Charcot joint can be confused with an infection involving these areas, and it may be difficult for your physician to differentiate these two conditions. By definition, a patient with a Charcot joint has decreased sensation in the affected area and peripheral neuropathy, which is most commonly due to diabetes. There are other causes of peripheral neuropathy. However, they are much less common than diabetes. As a result, it is common for persons with diabetes to experience peripheral neuropathy first, which is followed by Charcot joint. A high index of suspicion is generally required to make the diagnosis early in the disease process. A person with Charcot joint experiences swelling, pain, and increased skin temperature over the affected joint or joints. These are the same signs and symptoms that occur with infections, so this cause has to be considered as well. The use of weight-bearing or standing radiographs (x-rays) is essential not only to establish the diagnosis but also to determine the degree of destruction of the joints. Most patients with Charcot joint have acute inflammation without a history of trauma or cut or break in the skin, which would suggest an infection. Charcot joint is generally considered treatable but not curable.

Living With Your Diagnosis
Prevention is the key to minimizing the deformities that can occur. At the earliest onset of swelling, redness, and increased skin temperature directly over an affected joint or joints, contact your doctor. Ignoring the warning signs may lead to destruction of the joints with disintegration of the bones and collapse (Fig 1). Many times Charcot joint is an extremely painful condition, even though it occurs in areas affected by peripheral neuropathy. Persons with this severe pain usually seek treatment sooner than persons with little pain, who often do not seek treatment until the deformity becomes severe.

There are no medications available specifically to treat Charcot joint. The acute inflammatory phase is managed with immobilization of the extremity and use of crutches or a walker to decrease weight bearing or eliminate weight bearing through the extremity. It can take as long as 6 weeks for the acute inflammation to subside. After the inflammation subsides, the joint or joints are braced and likely require bracing or other support to prevent further flare-ups and destruction of the joints.

The DOs
• Control your diabetes with proper medication, diet, and exercise.
•Ê Should a Charcot joint develop, modify the exercise program to eliminate weight bearing. Substitute non<en>weight-bearing forms of exercise, such as cycling or water exercises.

The DON’Ts
• Do not begin an aggressive walking or running program immediately after being fitted with braces or splints.

When to Call Your Doctor
• If you notice the recurrence of swelling, heat, or redness around any weight-bearing joint, particularly if it recurs in a joint that was treated.