Chronic Charcot and superimposed osteomyelitis.

Chronic stage of Charcot:
The chronic stage of Charcot no longer shows a warm and red foot, but the edema usually persists.
Joint deformity, subluxation and dislocation of the metatarsals lead to a rocker-bottom type deformity in which the cuboid becomes a weight-bearing structure.
The deformity of the foot with abnormal pressure distribution on the plantar surface coupled with reduced or loss of sensation, makes the foot vulnerable and leads to callus and blister formation aswell as foot ulceration.
Charcot with superimposed osteomyelitis:
Foot ulceration can subsequently lead to infections, such as cellulitis and osteomyelitis, and this may eventually lead to amputation.
The simplest method to determine whether osteomyelitis is present is to follow the path of an ulcer or sinus tract to the bone and evaluate the signal intensity of the bone marrow (1).
Osteomyelitis in chronic Charcot is usually located in the midfoot, while osteomyelitis in diabetic neuropathy without Charcot is usually in the forefoot and hindfoot.