Endocrine Abstracts

Case presentation: 73-year-old diabetic, hypertensive and alcoholic Male on treatment for type II diabetes for 25 years, underwent amputation of left great toe and second toe previously had sudden painless swelling of the left foot after a walk. He was diagnosed to have Charcot’s foot and had the appearance of bag of bones in CT scan. He was managed conservatively with immobilization and Custom made shoes.

Discussion: Charcot foot is a sudden softening of the bones in the foot that occurs in patients with severe neuropathy and resulting bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the arch collapses and the foot takes on a convex shape. Charcot foot is a very serious condition that can lead to severe deformity, disability, and even amputation. X-ray examination reveals the appearance of lysis of the bones with marked fragmentation, absence of bone regeneration, the tendency to disarticulation and destruction of the joints and the complete flattening of the longitudinal arch of the foot. The ‘club foot’ appearance in conjunction with the radiologic findings merits the appellation ‘a bag of bones.’¹