Charcot Joint Disease (Degeneration of a Weight-Bearing Joint)

Originally described by Jean-Marie Charcot in 1868 in patients with syphilis, and later recognized by William Jordan in diabetic patients in 1936, this condition is characterized by destructive changes in weight-bearing joints due to sensory nerve damage.

To develop Charcot, three key factors are typically present:

• Peripheral sensory neuropathy – often related to diabetes or other neurologic conditions, causing loss of pain perception in the foot.
• Normal or increased blood flow – circulation is usually intact, sometimes even hyperactive, which fuels bone resorption.
• A minor injury or trauma – frequently unrecognized by the patient due to numbness, leading to repeated microtrauma.

Because patients cannot feel pain, they continue to walk on the injured foot, worsening the internal damage over time.

• Redness, warmth, and swelling in the foot or ankle (often mistaken for infection)
• Rocker-bottom foot deformity
• Instability when walking or standing
• Sudden or gradual onset of foot shape changes
• Little to no pain despite significant bone injury

Early recognition is critical — Charcot foot can rapidly progress if not treated immediately.

Diagnosis is made based on:

• Clinical exam and history of neuropathy (especially in diabetic patients)
• Imaging studies including X-rays, MRI, or CT scans
• Temperature comparison between limbs (affected foot may be significantly warmer)

At SoCal Foot and Ankle Doctors, our team uses advanced diagnostic techniques to distinguish Charcot foot from infection, cellulitis, or osteomyelitis, which may appear similar.

Immediate offloading and immobilization is the cornerstone of Charcot treatment.

Non-Surgical Treatment Includes:

• Total contact casting to reduce pressure and allow healing
• Custom bracing or CROW boot (Charcot Restraint Orthotic Walker)
• Blood sugar control in diabetic patients
• Custom shoes or orthotics once the active phase resolves

In cases of severe deformity, ulceration, or instability, surgical reconstruction may be required to:

• Realign the foot
• Stabilize joints with internal hardware or external fixation
• Prevent limb loss

Surgery is considered after the acute phase has resolved and inflammation has stabilized.

Charcot foot is a limb-threatening condition that requires immediate attention from a podiatric specialist. If you have diabetes, neuropathy, or unexplained foot swelling, contact SoCal Foot and Ankle Doctors today. With locations in Santa Monica and Cedars-Sinai Medical Towers, we are trusted by patients across West LA for early diagnosis and expert care.