[3] The diagnosis of Charcot neuroarthropathy is made clinically and should be considered whenever a patient presents with warmth and swelling around a joint in the presence of neuropathy.

[1] Early recognition, patient education, and protection of joints through various offloading methods is important in treating this disorder.

Inflammation, erythema, pain and increased skin temperature (3–7 degrees Celsius) around the joint may be noticeable on examination.

These findings in the presence of intact skin and loss of protective sensation are pathognomonic of acute Charcot arthropathy.

Roughly 75% of patients experience pain, but it is less than what would be expected based on the severity of the clinical and radiographic findings.

Any condition resulting in decreased peripheral sensation, proprioception, and fine motor control: Two primary theories have been advanced: In reality, both of these mechanisms probably play a role in the development of a Charcot joint.

Diabetes is the foremost cause in America today for neuropathic joint disease,[5] and the foot is the most affected region.

Over half of diabetic patients with neuropathic joints can recall some kind of precipitating trauma, usually minor.

Pressure relief (offloading) and immobilization at the acute (active) stage[7] are critical to helping ward off further joint destruction in cases of Charcot foot.

This redistributes pressure from the foot into the leg, which is more able to bear weight, to protect the wound, letting it regenerate tissue and heal.

[7] Duration and aggressiveness of offloading (non-weight-bearing vs. weight-bearing, non-removable vs. removable device) should be guided by clinical assessment of healing of neuropathic arthropathy based on edema, erythema, and skin temperature changes.