What are the key clinical features to consider when diagnosing Charcot foot in a patient with diabetes?

When diagnosing Charcot foot in a patient with diabetes, the key clinical features to consider include redness, warmth, swelling, and deformity of the foot, particularly when the skin remains intact. These signs are especially significant in the presence of peripheral neuropathy or renal failure. It is important to suspect acute Charcot arthropathy even if deformity is not present or if the patient does not report pain. Additionally, a history of foot or ankle fracture in a person with diabetes should raise suspicion for progression to Charcot arthropathy. Confirmatory investigations include weight-bearing X-rays of the affected foot and ankle, and if these are normal but suspicion remains, an MRI should be considered. Prompt referral to a multidisciplinary foot care service is recommended for diagnosis confirmation and management initiation. Non-weight-bearing treatment should be offered until definitive treatment begins.