Does the point of healthcare contact affect successful diagnosis of diabetic Charcot neuroarthropathy?

Abstract

Background: Charcot neuroarthropathy (CN) is a lesser-known and commonly misdiagnosed diabetic foot complication. Delays in diagnosis increase the risk of severe long-term foot complications. Aims: To undertake a retrospective audit of patients with active CN, recording the time to diagnosis, misdiagnosis rates, healthcare professional (HCP) and setting type at each contact since symptom onset prior to their referral to a multidisciplinary foot team (MDFT) clinic in a circumscribed part of England. Methods: Clinical notes of 46 consecutive patients attending a MDFT clinic in the East Midlands region of England during a 2-month period, with active CN were assessed. Results: Of the 46 included patients, 22 developed CN while in primary care. These patients had a mean time from symptom onset to confirmed diagnosis of 68 days, with 64% receiving a misdiagnosis. Non-specialist HCPs failed to suspect CN in 85% of contacts compared to 20% in specialist HCPs. Conclusions: Non-specialist HCPs need a greater degree of awareness and understanding of CN to reduce diagnostic delays and misdiagnosis rates