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Next Step Foot & Ankle Clinic

A Red, Swollen Foot Doesn't Always Mean an Infection

"Hi, this is Dr. Silvester and I want to talk to you today about something that’s come into my office twice in the last two weeks. It’s pretty serious. It happens to patients who have numbness in their feet, most of the time they’re diabetics but there are other conditions that can contribute to it as well. Both of these patients had developed swelling and redness and warmth in their foot. One went to an emergency room and one went to an urgent care doctor. They got x-rays, they got some blood tests and were told they had an infection, because the foot was red and swollen. They didn’t have any sores on their feet where the infection could get inside, but sometimes you can get infections through the bloodstream, but that’s what they were diagnosed with and they were given antibiotics.
They were also asked to schedule an appointment with a podiatrist, and they came to see me. Both of these patients, I looked at them and evaluated them and they had something that was much more serious than an infection and had nothing to do with an infection. When you have numbness and reasonably good circulation in a foot, you can develop what’s called Neural Arthropathy and there’s another name for that called Charcot foot. Charcot was a neurologist in France, he saw a lot of people who had this condition so it got named after him. 
 
In a Charcot foot, the bones start getting small micro-fractures in them. As a result of these fractures, the foot starts to swell and it starts to get red and sometimes it hurts (a lot of times it doesn’t because the patient doesn’t have very good nerve function). What happens eventually is the foot can eventually collapse.
 
Fortunately, both of these patients came in early, before their foot collapsed and we were able to hopefully arrest the process with a series of treatments. If you have diabetes and numbness and you start to get a red, swollen foot, do not walk on it and find yourself a really good podiatrist and get that checked out for Charcot feet. Don’t assume just because it’s red and swollen and you have diabetes that you have an infection. That’s not necessarily the case. It can be, but a lot of times it’s very easy to misdiagnose and it has very serious consequences unless it’s treated early and aggressively. So thank you very much for listening - watch out for that red foot!"