Forefoot Osteolysis Revealing a Charcot Osteoarthropathy

Charcot osteoarthropathy, also known as Charcot foot or neuroarthropathy, has been recognised for over 130 years. Yet it remains a major cause of morbidity for patients with diabetes mellitus and a continuing challenge for physicians, as well as for public health because of the massive economic consequences of foot ulcers. Acute Charcot osteoarthropathy is a skeletal breakdown associated with inflammatory swelling of a foot in patients with pain insensitivity. Charcot osteoarthropathy can be classified into five different types, depending on the anatomical site involved: forefoot, tarsometatarsal joints, Chopart joint, ankle or calcaneus [1]. Midfoot Charcot osteoarthropathy is the most common form (more than 80%), and is in general easily recognized with the classic rocker-bottom subluxation of the midfoot [1]. On the opposite, forefoot Charcot osteoarthropathy is less well known and is probably underdiagnosed as the external deformities are minimal.