A hot, swollen foot that does not hurt. A normal X-ray. A diagnosis missed for weeks. This episode is about the diabetic foot complication that is very treatable when caught early, and devastating when it is not: Charcot neuro-osteoarthropathy.

We break down the four things that decide whether a patient keeps their foot or loses it. First, why a hot, swollen, neuropathic foot should be treated as Charcot until proven otherwise. Second, why an MRI sees what a plain X-ray cannot, and how to tell Charcot apart from a bone infection. Third, why the total contact cast is still the cornerstone of treatment, and why even standing on the foot too much can undo it. Fourth, how the way a service is built, rapid access and same-day referral, often matters more than any single clinician’s knowledge.

Whether you are a clinician who sees feet, or someone living with diabetes and reduced sensation, the message is the same and worth remembering: if one foot suddenly becomes hot, swollen or a different shape, get it seen the same day and keep the weight off it.

Clear, practical, and grounded in the current evidence, including the 2023 international guidelines.

Please note: this episode uses an AI-generated voice. The clinical content is researched and reviewed by Rob Menzies.