Foot and Ankle Surgeons Warn of Diabetic Foot Condition That’s Often Misdiagnosed

For nearly 30 million Americans with diabetes, there is a debilitating and often preventable foot condition that is underdiagnosed and undertreated. A lack of awareness of Charcot foot (pronounced shar-koh) means that many patients undergo painful surgeries, and even amputations, to correct what can be a highly treatable condition.

Charcot foot is the result of peripheral neuropathy, a condition that results in the loss of feeling in the lower extremities, including the feet. An estimated one third of all diabetic patients develop peripheral neuropathy. This lack of feeling can lead to increased blood flow along with nerve problems in the feet, which can result in development of Charcot foot. Without proper care, Charcot foot can lead to permanent deformity, disability and even result in amputation of the leg and foot.

According to the American College of Foot and Ankle Surgeons (ACFAS), Charcot foot is highly treatable when caught early. Doctors and patients agree that early detection is the key. Unfortunately, the condition is often misdiagnosed because its symptoms can be attributed to other problems.

Annita Shaw, a retired school teacher and diabetic, knows this all too well.  Shaw visited the emergency room three times for foot pain over several years, before finding a foot and ankle surgeon who ultimately diagnosed her with Charcot foot.

“Several physicians suggested my foot pain was due to arthritis or that my shoes were too tight. No one x-rayed my feet. Finally I found a physician specializing in foot and ankle care, who determined that Charcot was the cause of my ongoing foot problems,” says Shaw.

In the early stages of Charcot foot, bones of the foot become weak and may fracture. With continued walking, the foot changes shape and, as the disorder progresses, joints collapse and the foot takes on an abnormal shape. Because they cannot feel pain, many people do not realize they have Charcot foot until this late stage, when severe complications have occurred.

“People think they don’t have a problem because they feel no pain, but that isn’t the case,” says Valerie L. Schade, DPM, FACFAS, FACFAOM, a foot and ankle surgeon in Tacoma, Washington and a Fellow Member of ACFAS, who now treats Shaw. “Anyone at risk for neuropathy, including diabetics, alcoholics and some chemotherapy patients, should see a foot and ankle surgeon early and at least once every year, even if they are considered low risk.”

ACFAS surgeons know that monitoring for changes in the foot is the single most important factor in prevention. Dr. Schade continues, “Anyone who notices a difference—discomfort, unexplained swelling or redness, or changes to the shape of the foot—should seek care right away.”

As for Shaw, who was able to avoid amputation, she now spends much of her time advocating for greater awareness of Charcot foot, informing and educating at-risk patients and the general public. “If I can save even one person from the pain of surgery or amputation by raising awareness of Charcot foot, I’ll have done my job,” Shaw continues. “People spend so much time and money worrying about aging and maintaining beauty, when really they should spend time caring and worrying about their feet!”

For more information on Charcot or other foot and ankle health information, visit the American College of Foot and Ankle Surgeons’ patient education website at FootHealthFacts.org.

Source: The American College of Foot and Ankle Surgeons, a professional society of over 7,000 foot and ankle surgeons. Founded in 1942, the College’s mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its patient education website FootHealthFacts.org.