夏科氏足是好發於跗骨與蹠骨的疾病，常見於糖尿病合併神經病變的病患。紅、腫、痛等急性夏科氏足的臨床表現與蜂窩組織炎或骨髓炎類似。我們報告一位62 歲糖尿病女性，因為左足發紅與腫痛4 個月，接受抗生素治療3 週病況未改善而至本院求診。理學檢查顯示左足紅、腫、壓痛但無溫度異常。左足X 光片顯示蹠骨碎片與骨侵蝕。磁振照影確定為糖尿病合併夏科氏足，Lisfranc 韌帶撕裂與Lisfranc 關節脫位。病患接受石膏與支架固定左足，隨後因足部關節不穩定而接受手術治療。糖尿病病患出現足部紅腫疼痛使用抗生素治療無效，特別是足部X 光片發現骨碎片時應排除是否為夏科氏足。

Charcot foot most often affects the metatarsals and the tarsals, and mostly occurs in diabetic patients with neuropathy. Clinical findings in patients with acute Charcot foot include erythema, swelling and heat, which may mimic cellulitis or osteomyelitis. We report a 62-year-old diabetic woman presented with painful erythematous swelling over left foot for 4 months. She had been treated with antibiotics for 3 weeks at another hospital under the diagnosis of left foot cellulitis but without improvement. Physical examination revealed erythema, swelling,and tender in left foot without temperature difference from right foot. Foot radiograph demonstrated one bony fragment at left metatarsal bone with erosion. Charcot joint with underlying diabetic foot, complicated with Lisfranc ligament tear and dislocation was confirmed by magnetic resonance imaging. The left foot was immobilized with a total contact cast and post-cast brace, followed by open reduction and internal fixation due to poor adherence of brace and poor stabilization of foot joints. Charcot foot should be suspected in any diabetic patient presenting with persisted painful erythematous swelling of foot not responded to antibiotic, especially foot radiograph showed bone
fragments.