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Charcot Foot - possibly not
- Thread starter akb
- Start date
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Flower
Well-Known Member
- Relationship to Diabetes
- Type 1
Hello and welcome @akb, sorry to hear you're having foot problems.
Charcot can be mistaken for other issues such as infection /osteomyelitis /sprain etc but the best approach in someone with diabetes is to rule Charcot out through scans and monitor and protect the foot to try and prevent potential long term damage. It is quite a rare complication which isn't seen that often and can be mistaken for other more common problems so the best approach is to err on the side of caution. It is better to be over protective than dismiss something that turns out to be more serious.
What symptoms has your potential diagnosis been based on?
Charcot can be mistaken for other issues such as infection /osteomyelitis /sprain etc but the best approach in someone with diabetes is to rule Charcot out through scans and monitor and protect the foot to try and prevent potential long term damage. It is quite a rare complication which isn't seen that often and can be mistaken for other more common problems so the best approach is to err on the side of caution. It is better to be over protective than dismiss something that turns out to be more serious.
What symptoms has your potential diagnosis been based on?
akb
New Member
- Relationship to Diabetes
- Type 1
thanks guys for your replies.
@KARNAK hope all is ok with your right foot and gets sorted soon
@Flower it has been a long haul till now and still ongoing!! the only signs is the temperate difference - and it is not always higher in the affected foot in fact it was -2c lower on one occasion. The surgeon thinks it is not charcot however the foot doctor says it is. My foot has a slight bulge to the side but no indication of any problem on x-rays. Bloods are all normal for infection as there was talk at one point that it could be an infection in the bone as I had an open sore on the same foot middle toe on and off for a year (claw toe caused that!)
I understand that the only prevention for further damage of charcot is non weight bearing for as long as it takes but feel foot doctor is not looking at other possibilities which are outside of his remit.
This has been since November when the podiatrist I saw at my routine appointment thought I had suspected charcot foot so referred me to the hospital to be reviewed by the foot doctor who wasn't sure but as a precaution immobilised me into an air boot. He explained that due to the difference in temperature between my feet and the swelling to the side that it could be charcot foot, however the x-rays didn't show any signs. I had an operation in Oct 2017 - 5 fractures in my left foot but with no recollection of how it happened in April that year (I didn't have a hypo I believe my drink was spiked) the 2nd metatarsal didn't heal back so it was decided to operate.
Since November I went from the boot to a full cast (which was just a nightmare) now back to the boot as just couldn't cope / function in a cast during this time have had several x-rays and an MRI which have all shown no results of charcot foot.
In April the surgeon who had operated gave a second opinion and said he didn't think it was charcot foot and to go back to wearing the boot then into shoes again. This was fine for 2 weeks then over the easter weekend had to go to A and E due to my foot being so swollen and also high sugars due to an infection, also had a very high raised heart rate over previous 2 weeks and ever since! They ruled out DVT, micro fractures and gout and discharged me as I had another check up with the foot doctor that week.
I get that it is best to be cautious, but this has had such an impact on my life - continuous additional appointments, not being able to go about every day activities, having to sell my manual car for an automatic - for something that might not even be charcot and if it's not then what it is - is being missed!
sorry such a long reply!
@KARNAK hope all is ok with your right foot and gets sorted soon
@Flower it has been a long haul till now and still ongoing!! the only signs is the temperate difference - and it is not always higher in the affected foot in fact it was -2c lower on one occasion. The surgeon thinks it is not charcot however the foot doctor says it is. My foot has a slight bulge to the side but no indication of any problem on x-rays. Bloods are all normal for infection as there was talk at one point that it could be an infection in the bone as I had an open sore on the same foot middle toe on and off for a year (claw toe caused that!)
I understand that the only prevention for further damage of charcot is non weight bearing for as long as it takes but feel foot doctor is not looking at other possibilities which are outside of his remit.
This has been since November when the podiatrist I saw at my routine appointment thought I had suspected charcot foot so referred me to the hospital to be reviewed by the foot doctor who wasn't sure but as a precaution immobilised me into an air boot. He explained that due to the difference in temperature between my feet and the swelling to the side that it could be charcot foot, however the x-rays didn't show any signs. I had an operation in Oct 2017 - 5 fractures in my left foot but with no recollection of how it happened in April that year (I didn't have a hypo I believe my drink was spiked) the 2nd metatarsal didn't heal back so it was decided to operate.
Since November I went from the boot to a full cast (which was just a nightmare) now back to the boot as just couldn't cope / function in a cast during this time have had several x-rays and an MRI which have all shown no results of charcot foot.
In April the surgeon who had operated gave a second opinion and said he didn't think it was charcot foot and to go back to wearing the boot then into shoes again. This was fine for 2 weeks then over the easter weekend had to go to A and E due to my foot being so swollen and also high sugars due to an infection, also had a very high raised heart rate over previous 2 weeks and ever since! They ruled out DVT, micro fractures and gout and discharged me as I had another check up with the foot doctor that week.
I get that it is best to be cautious, but this has had such an impact on my life - continuous additional appointments, not being able to go about every day activities, having to sell my manual car for an automatic - for something that might not even be charcot and if it's not then what it is - is being missed!
sorry such a long reply!
Flower
Well-Known Member
- Relationship to Diabetes
- Type 1
Hello @akb ,
I was quite recently referred to Kings College London diabetic foot team who are world leaders in treating Charcot and other diabetic foot problems. I don't know which part of the UK you're in but I was so grateful for their input into my situation. It could be worth getting a referral to them for another opinion as to what is happening - that's assuming you don't already go to KCH!
Charcot is certainly a very complex complication and I'm really sorry you're facing ongoing problems with diagnosis. My right foot is classic Charcot, fractured metatarsals with foot shape deformities, collapsed arch, collapsed ankle. My left foot is also classified as Charcot but hasn't followed the same path. Multiple fractures, hot, swollen with bone necrosis then cooling but no deformity (thank goodness). It has been in a cast or boot on and off for years every time something else goes wrong but is a mix up of problems.
I hope you can get some clarity as to what is happening but know from my experience that some changes didn't initially show on X rays, the temperature of my feet dropped then increased again over time and the default position was a cast to try and protect from further deformities.
I know how utterly wretched and devastating it is on day to day life and wish you well with it all.
I was quite recently referred to Kings College London diabetic foot team who are world leaders in treating Charcot and other diabetic foot problems. I don't know which part of the UK you're in but I was so grateful for their input into my situation. It could be worth getting a referral to them for another opinion as to what is happening - that's assuming you don't already go to KCH!
Charcot is certainly a very complex complication and I'm really sorry you're facing ongoing problems with diagnosis. My right foot is classic Charcot, fractured metatarsals with foot shape deformities, collapsed arch, collapsed ankle. My left foot is also classified as Charcot but hasn't followed the same path. Multiple fractures, hot, swollen with bone necrosis then cooling but no deformity (thank goodness). It has been in a cast or boot on and off for years every time something else goes wrong but is a mix up of problems.
I hope you can get some clarity as to what is happening but know from my experience that some changes didn't initially show on X rays, the temperature of my feet dropped then increased again over time and the default position was a cast to try and protect from further deformities.
I know how utterly wretched and devastating it is on day to day life and wish you well with it all.
Last edited:
akb
New Member
- Relationship to Diabetes
- Type 1
Thanks so much for your reply Flower - sorry to hear charcot is affecting both your feet
Going to ask for a referral to Kings College - I am in Ealing and was going to ask when I go on the 10th for my appointment with the foot doctor and surgeon for a referral - someone at my gp said about a doctor at west middlesex but definitely needs to be in the charcot field, thanks for the suggestion.
Good luck with everything and thanks again
Angela
Northerner
Admin (Retired)
- Relationship to Diabetes
- Type 1
akb
New Member
- Relationship to Diabetes
- Type 1
Thank you very much
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