Abstract
INTRODUCTION: The 'acclimatization time' before temperature assessment for diagnosis and monitoring of active unilateral Charcot neuro-osteoarthropathy (CNO) of foot is not known. Therefore, we aimed to assess the appropriate acclimatization time for foot temperature at diagnosis and during follow-up assessment of patients with active CNO. METHODS: Patients of diabetes with active unilateral CNO of foot were assessed for inter-feet temperature difference [affected foot-unaffected foot (°C)] at 10-, 30- and 45-minutes following shoe-off with a handheld infrared dermal thermometer. The primary objective was to assess the significance of different individual and paired time points for inter-feet temperature differences. RESULTS: Overall, 30 patients were recruited and 96 paired inter-feet temperature difference readings were obtained. The median inter-feet temperature difference at 10 minutes was 3°C (2.4-4.4°C), 30 minutes was 3.2°C (2.5-4.45°C) and 45 minutes was 3.3°C (2.3-4.63°C) (P = 0.623). The correlation between paired temperature readings at 30 and 45 minutes (r = 0.914; P < 0.001) was better than that at 10 and 30 minutes (r = 0.724; P < 0.001). CONCLUSION: Paired inter-feet temperature difference obtained at 30 and 45 minutes following footwear removal is clinically-meaningful for the diagnosis and monitoring of active unilateral CNO of feet.