A patient with diabetes mellitus walks into your office with a chief complaint of a swollen left foot. He has no history of trauma and no major discomfort. His main concern is that his foot no longer fits inside his shoe. A radiograph shows a Lisfranc fracture-dislocation. For the physician who has not dealt with diabetic patients on a daily basis, the idea that a patient with a severe traumatic injury could walk into the office with neither a history of trauma nor pain seems farfetched. As the patient is diabetic, a diagnosis of infection or possibly osteomyelitis seems more realistic. The patient is managed with intravenous administration of antibiotics and perhaps a bone biopsy; an amputation may follow. Non-weight-bearing, use of a cast, and open reduction and internal fixation are not considered as part of the treatment regimen. The Charcot foot is one of the most misdiagnosed and mistreated problems seen in diabetic patients.