Infrared Thermography and Vascular Disorders in Diabetic Feet

Abstract

Aim: Diabetes mellitus (DM) and related foot complications constitute a growing healthcare burden. Diabetes mellitus is associated with lower-limb amputation, but diabetic foot assessment is challenging. Here, we evaluated a novel noninvasive diagnostic method—infrared thermography (IRT) —assessing its diagnostic potential compared to conventional noninvasive measurements. Methods: This study included patients with DM ( n = 118) and healthy controls ( n = 93). All participants underwent ankle brachial index and toe pressure (TP) measurements, and IRT using a standardized protocol with temperature measurement at five foot areas. Results: Compared to controls, patients with DM generally had warmer feet and exhibited a significantly greater temperature difference between feet ( P < .001). Mean temperatures were highest in patients with DM with neuroischemia, followed by neuropathy. Patients with DM with angiopathy showed the lowest mean temperature—similar to controls and noncomplicated diabetics. Mean temperatures at all measurement sites were significantly higher with abnormal TP (<50 mmHg) than normal TP (≥50 mmHg) ( P < .001). Infrared thermography revealed differences between angiosome areas, subclinical infections, and plantar high-pressure areas. Conclusion: Infrared thermography revealed local temperature differences in high-risk diabetic feet. Normal skin surface temperature varies between individuals, but in combination with other tools, IRT might be useful in clinical screening. ClinicalTrials ID: 14212016

Infrared Thermography Follow-Up After Lower Limb Revascularization

“…As reported in our previous studies, we have investigated the use of IRT as a diagnostic tool among PAD patients and patients with diabetes. 21,22 Our outcome here in the present study strengthens these earlier findings and suggests that one of the most effective ways to use IRT is to use it as a follow-up tool among people with diabetes. It is also a valuable tool in the follow-up of PAD patients and patients with diabetes, who have had previous revascularization.…”

“…IRT can be a revealing tool, especially among people with diabetes, and provides valuable information among PAD patients; however, temperature variation is not as broad as among patients with diabetes. 21,22 Surgical or endovascular procedures for stenotic arteries of leg peripheral circulation are intended to lead to sufficient blood flow. The purpose of this study was with a simple clinical setting to compare skin temperature changes in the feet before and after revascularization and to identify possible correlation between ABI and TP values and foot skin temperature.…”

Infrared Thermography as a Diagnostic Tool for the Assessment of Patients with Symptomatic Peripheral Arterial Disease Undergoing Infrafemoral Endovascular Revascularisations

“…Infrared thermography has been proposed as a diagnostic tool for the assessment of foot perfusion as a contact-free examination that is non-invasive and not influenced by the operator experience [ 13 , 14 ]. This exam could have a diagnostic role in evaluation of the diabetic foot, infectious processes and other inflammatory conditions, such as vasculitis, where an increase in the skin foot temperature is likely to be found [ 15 , 16 ]. Furthermore, IRT has been studied to assess the technical success of endovascular procedures for PAD patients [ 17 ].…”

Modeling, Fabrication and Integration of Wearable Smart Sensors in a Monitoring Platform for Diabetic Patients

“…As regards the sites that are likely to ulcerate, a study about a population of 87 patients with active foot ulcer [ 40 ], calculated the probability of occurrence of ulcerative lesion under the metatarsal heads (56.3%), toes (32.1%), and heel (1.9%). Numerous works correlated the variations of plantar foot temperature to neuropathy and peripheral vascular diseases [ 41 , 42 , 43 , 44 ].…”