Clinical recommendation Evidence rating References
In patients with suspected acute Charcot neuroarthropathy, early and accurate diagnosis and prompt immobilization reduce the incidence of rigid foot deformity development, which increases patient quality of life and reduces the risk of ulceration, infection, and amputation. C 26, 811, 14, 17, 2029
The diagnosis of acute Charcot neuroarthropathy should be considered in any patient 40 years or older with obesity and peripheral neuropathy who presents with a unilateral swollen limb and minimal or no associated pain. C 212, 14, 1820, 2225, 2937
Acute Charcot neuroarthropathy should be considered in patients with recurrent cellulitis but no systemic or laboratory findings concerning for infection. C 214, 22, 30, 38, 42
Bilateral weight-bearing radiography is recommended to allow for comparison between both feet in persons with suspected acute Charcot neuroarthropathy. Clinicians should look for signs of subtle subluxations or ligamentous avulsion, which denote impeding osseous instability. C 24, 912, 14, 20, 2226, 30, 38, 39