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Figure C
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Figure D
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This diabetic patient with a plantar midfoot ulcer most likely has Charcot arthropathy of the foot. This is shown radiographically in Figure C as evident by the midfoot destruction and joint subluxation. Charcot arthropathy occures in 7.5% of neuropathic diabetics. Wukich et al described an 83% rate of ulcer healing with total contact casting in neuropathic ulcers and noted a 17% rate of complications (most being due to skin irritation from the cast). Figure A shows a homolateral Lisfranc injury and Figure B shows a hallux valgus deformity. Figure D shows a radiograph of a cavus foot often associated with Charcot Marie Tooth disease. Figure E shows a radiograph of an acquired flatfoot deformity with midfoot subluxation but there is absent fragmentation, osteopenia, or bony destruction indicating Charcot arthropathy of the foot.
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