Burning Issues/Hot Topics: The Charcot Foot

TL;DR

This paper reviews the Charcot foot, a serious complication of diabetes, focusing on early detection and management to prevent severe outcomes.

Contribution

The paper offers a comprehensive, evidence-based review of clinical approaches to diagnosing and managing Charcot neuro-osteoarthropathy.

Findings

Early recognition of Charcot foot is critical to prevent irreversible damage.

Combining clinical observation with imaging improves early diagnosis.

Multidisciplinary care is essential for effective long-term management.

Abstract

Charcot neuro-osteoarthropathy remains one of the most serious complications of diabetic neuropathy, with the potential for rapid progression to deformity, ulceration and limb-threatening outcomes. The earliest signs and symptoms are often subtle and easily missed, yet early recognition provides a narrow window of opportunity to prevent irreversible structural change. Contemporary diagnostic pathways are underpinned by close clinical observation and correlation of bedside findings with detailed imaging analysis, enabling earlier identification of active disease before collapse occurs. This article provides a comprehensive overview of the Charcot foot, integrating clinical presentation, differential diagnosis and current approaches to investigation and management. It also highlights the challenges of monitoring disease activity over time, including remission and relapse, and the importance of timely specialist referral and multidisciplinary management. By reinforcing structured assessment and targeted intervention, this review aims to support consistent, evidence-informed care for people affected by Charcot neuro-osteoarthropathy.

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