What are the NICE treatment guidelines for Charcot arthropathy?

Updated: Jun 21, 2018
  • Author: Mrugeshkumar Shah, MD, MPH, MS; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

If the multidisciplinary foot care service suspects acute Charcot arthropathy, treatment with a nonremovable offloading device should be offered. If the use of such a device is inadvisable because of clinical or patient circumstances, treatment with a removable offloading device should be considered.

The use of bisphosphonates to treat acute Charcot arthropathy is not warranted, unless as part of a clinical trial.

Treatment of acute Charcot arthropathy should be monitored via clinical assessment, to include measurement of foot-skin temperature difference and serial radiographs until the acute Charcot arthropathy resolves. Resolution is likely when there is a sustained temperature difference of less than 2º between the two feet and when radiographic changes show no further progression.

People who have a foot deformity that may be the result of a previous Charcot arthropathy are at high risk of ulceration and should be cared for by the foot protection service.


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