Charcot foot, also called neurogenic arthropathy, is a condition in which the bones in a joint degenerate from nerve damage. "Dorland’s Illustrated Medical Dictionary" states that the name “Charcot” comes from a French neurologist, Jean Martin Charcot, who explained the cause and effect of the disease in the late 1800s. Attributed to a number of conditions, Charcot foot most often stems from diabetes.
Diabetic Neuropathy
Diabetics have an excess of blood sugar in their bodies. The body uses it what it needs and the extra sugar circulates in the blood vessels. Because of sugar’s acidic nature, it corrodes the blood vessel walls. Lack of blood to any area kills nerve tissue. Charcot foot results from nerve tissue death, neuropathy, which robs the many bones and joints of the foot of their necessary nutrients. The smallest vessels and those farthest from the heart deteriorate first. Because of this, diabetics often have very little sensation in their feet. Unaware when they sustain an injury to their feet, diabetics and others with Charcot foot continue to walk painlessly while their brittle bones shatter under their weight.
Spinal Cord Disease and Injury
According to "Harrison’s Manual of Medicine," tabes dorsalis, a spinal cord disease, destroys the outer sheathing of some of the columns and roots of the spinal cord. The condition results in the loss of sensation to the body part innervated by the damaged nerves. This phenomenon appears in the late stage of syphilis. Besides disease processes, injury to the spinal cord also radiates to nerves stemming from that portion of the spine. Fractures in the foot tend to shatter under the weight of the entire body.
Peripheral Nerve Injury
The limbs at the periphery of the body can suffer injuries directly at the site. When something heavy drops on the foot, the injury can cause nerve damage. Unlike skin, nerves take a long time to regenerate. The wound may heal and the bone may mend, but sometimes the nerve damage becomes permanent. Without innervation, the joints and bones of the foot lose their integrity, leaving them susceptible to breakage.
Medications
Over time, certain medications given to organ transplant recipients cause peripheral nerve damage called neuropathy. Drugs like corticosteroids and immunosuppressants, which prevent rejection of the transplanted organ, have an injurious effect on nerves and blood vessels. The damage accumulates over many years, as transplant patients need to stay on these drugs for the rest of their lives. Although these drugs serve as these patients' lifeline, the side effects can eventually catch up with them.
References
- "Dorland's Illustrated Medical Dictionary"; Saunders Elsevier; 2007
- "Harrison's Manual of Medicine"; Anthony S. Fauci, et al. (eds.); 2009
