Red hot foot … keep Charcot arthropathy in mind
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* Adam Zanbilowicz

This is in response to a recent practice aticle in *CMAJ*.1 Although infection and gout are likely diagnoses in this presentation, Charcot arthropathy needs to be high up on the differential diagnosis list — particularly when a patient has diabetes.1 The presence of pain is not sufficient to rule out this rapidly deforming disease, and early imaging may not detect the developing process. Prompt intervention (non-weight bearing) can prevent life-altering disfigurement. As a podiatrist, I often see patients with Charcot arthropathy only after the foot has collapsed — early foot protection could have protected their mobility.

## Footnotes

*   **Competing interests:** None declared.

## Reference

1.  Farris GR, Steinhilber S. An older patient with diabetes and severe foot pain. CMAJ 2017; 189: E73–5.
    
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