Practice Points

• The majority of deformities in stage 2 can be accommodated in special footwear

• Callus is an important precursor of ulceration and should be treated aggressively, especially in the neuropathic foot

• The cold, pink, painful foot is an indication of severe ischaemia and requires urgent vascular intervention

• Patients must understand the implications of lack of protective pain sensation

• Education in trauma prevention is important

• Patients with painful neuropathy will need therapy of various modalities which should be delivered in a supportive environment

• Early diagnosis, immediate cast immobilization and careful rehabilitation are important for successful management of Charcot's osteoarthropathy.

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