When should I refer a patient with Charcot foot to a specialist for further management?

Refer a patient with suspected acute Charcot arthropathy to a specialist multidisciplinary foot care service within 1 working day for triage within 1 further working day. This urgent referral is necessary to confirm diagnosis and initiate appropriate management.

Until specialist assessment, offer non-weight-bearing treatment to prevent further foot damage.

Arrange a weight-bearing X-ray of the affected foot and ankle promptly; if normal but suspicion remains, consider MRI.

Once referred, the multidisciplinary foot care service will manage treatment, typically with a non-removable offloading device unless contraindicated.