Pathophysiology and etiology of the Charcot foot

Despite extensive research, the pathophysiology of Charcot foot is still not fully understood. In the case of late diagnosis and insufficient therapy, severe deformity may occur. Different theories on the pathophysiology of the Charcot foot are presented and discussed. This article presents different theories on the pathophysiology of the Charcot foot and presents studies on the cellular, immunological, and bone metabolism level. One theory is based on repetitive microtraumas in the sensoric deficient foot which lead to development of Charcot foot. Another theory is based on pathologic neurovascular innervation leading to morphologic changes. Probably both mechanisms are responsible in combination as etiological factors inducing neuropathy A combination of mechanical, vascular, and biologic factors induce the neuropathic foot and result in severe deformity if diagnosis is too late.