Evidence brief
Charcot Neuroarthropathy: Staging and Management
Stage 0 (Prodromal): swelling, warmth, normal X-ray
Stage I (Development): fragmentation, subluxation
Stage II (Coalescence): absorption of debris, healing
Stage III (Reconstruction): consolidation, remodeling
Offloading critical in active disease
Eichenholtz staging guides Charcot foot management. Active disease (Stage I) requires aggressive offloading; surgery typically deferred until coalescence.
Must know Eichenholtz stages. Key: differentiate acute Charcot (hot, swollen) from infection. MRI helps distinguish. Treatment: total contact cast or walker boot until coalescence. Surgical indications: instability, rocker-bottom deformity preventing bracing, ulceration. Understand Sanders/Frykberg classification for anatomic location.
Eichenholtz SN. Charcot Joints. Springfield, IL: Charles C Thomas; 1966.
Level IV
Case series or case reports