Infrared dermal thermometry for the high-risk diabetic foot

Background and Purpose. The purpose of this study was to compare skin temperatures in patients with asymptomatic peripheral sensory neuropathy, patients with neuropathic ulcers, and patients with Charcot's arthropathy using the contralateral limb as a control. Subjects. On a retrospective basis, patients with diabetes (N=143) were divided into three groups: patients with asymptomatic sensory neuropathy (n=78), patients with neuropathic foot ulcers (n=44), and patients with neuropathic fractures (Charcot's arthropathy) (n=21). Methods. We evaluated the subjects' skin temperatures with a portable hand-held infrared skin temperature probe at the time pathology was initially identified and at subsequent clinical visits for an average of 22.1 months (SD=6.4). Skin temperatures of the contralateral foot were measured as a control. Results. There were differences in skin temperature between the affected foot and the contralateral (ie, nonaffected) foot among the patients with Charcot's arthropathy (8.3°F) and the patients with neuropathic ulcers (5.6°F), with no difference identified among the patients with asymptomatic sensory neuropathy. Five patients with neuropathic ulcers experienced reulceration a mean of 12.2 months (SD=6.4) after initial healing, with a corresponding increase in skin temperature (89.6°±1.2°F versus 82.5°±2.9°F) at the clinic visit immediately preceding reinjury. Conclusion and Discussion. The data suggest that monitoring of the corresponding contralateral foot site may provide clinical information before other clinical signs of injury can be identified.