Abstract
Two patients with longstanding insulin-dependent diabetes mellitus (IDDM) complicated by neuropathy, nephropathy and retinopathy leading to poor vision each developed a swollen and relatively painless foot. The previous day, both had been walking over uneven ground. At initial presentation, no X-ray was taken of the foot in case one and no action was taken over an undisplaced navicular fracture in case two. A few weeks later, a midfoot Charcot had developed in both cases. Poor vision may increase the risk of injury to the feet and may be an important risk factor for Charcot neuro-arthropathy. Plain radiographs are an important investigation for the swollen insensitive foot, even in the absence of pain.
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