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Re: [IP] Charcot's Foot

In a message dated 05/21/1999 6:52:22 AM Central Daylight Time, 
email @ redacted writes:

<< High risk factors are listed as people with diabetes for more than 10
 years, who have loss of sensation in their feet, and are in their 50's and
 60's. People with eye, kidney or nerve complications "appear to be at the
 greatest risk for the development of bone and joint destruction".

Thank you for the wonderful post about Charcot's.  I would like to add a 
couple more things to complete the information you supplied.

In addition to the high risk factors listed, a broken bone in the foot or 
ankle combined with neuropathy can set off Charcot's.  A person can have a 
broken bone in their foot and not know about because the neuropathy is 
masking any symptoms. 

In simple terms, this is what I understand happens: In an effort to heal 
itself, the body increases the blood flow to the broken bone.  Because of the 
neuropathy it doesn't know when enough is enough, and over does it.  The 
severe increase in blood flow to the area creates excess heat (thus the 'hot 
to the touch' symptom).  This excess heat causes the bones to deteriorate and 

Charcot's has three different stages and effective treatment depends upon the 
stage when the disease is detected.  The first stage is the destruction of 
the bones.  At this time, the bones look all "mushy" and without distinct 
borders on an x-ray.  If caught in this stage, there is a good chance of 
stopping the destruction by eliminating pressure on the ankle and feet and 
immobilizing the bones until the disease has run it's course.  The second 
stage is reformation of the bones.  Think of the bones like dough and how 
pressure will form this.  If the disease is caught here the foot or ankle can 
be immobilized and the reformation can be stopped.  I don't know if there is 
anything that can be done to correct the shape of the bone but the 
destruction can be stopped.  The third is healing of the bones in their new 
shape.  Once this has occurred there is no way to reform the bones.  This 
whole process can take anywhere form 6 to 18 months.

As in everything else we deal with, the key is early detection.  

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