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Warning-sign checks

Charcot foot: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Toes that become cold, pale, blue, or difficult to move require immediate assessment.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Report a loose, damaged, wet, or painful cast or device promptly.

    Contact the treating team urgently if a cast or boot causes new rubbing, drainage, marked swelling, worsening pain, or numbness.

    A new warm or swollen foot should not wait for a routine appointment.

    Seek prompt assessment and reduce weight-bearing until a clinician advises otherwise.

  3. 3

    Does any of this apply?

    Book an appointment

    During active treatment, follow-up is usually frequent.

    The team may examine the skin, check swelling and warmth, assess the cast or boot, and repeat imaging when needed.

    Routine care may involve a diabetes clinician, podiatrist, foot and ankle specialist, orthotist, wound team, or physical therapist.

The article also says

After the active phase, lifelong foot surveillance is important.

Check both feet each day if possible.

Look at the soles and between the toes, using a mirror or another person’s help if needed.

Watch for redness, warmth, blisters, cracks, calluses, drainage, or a change in shape.

Avoid walking barefoot, including indoors.

Shoes and braces should be inspected for wear, rough seams, or objects inside.

New footwear may need to be introduced gradually and checked by a foot-care professional.

Calluses should not be cut at home, and over-the-counter corn removers can injure skin that has reduced sensation.

Every sign above is quoted from the sofidex article on Charcot foot. If you are not sure, err upward — it is always reasonable to be checked.