Thermal Imaging Today and Its Relevance to Diabetes
Figure 5: Dorsal view of feet. The left forefoot is inflamed (red) and toes are cold.
be saved. Spence and colleagues (20) studied
104 patients with ischemic limbs prior to
amputation in 1981 and concluded that the
thermographic method as they described
was a reliable indicator of the tissue viability
and could be used to indicate the level of a
major limb amputation. In a later paper in
1984, they discussed three methods in use for
amputation level assessment: partial oxygen
pressure, skin blood flow, and infrared
thermography. (21) One group, that compared
thermography with Doppler flowmetry
and clinical judgment of an experienced
surgeon, did not support their findings. Their
conclusion was that the experienced surgeon
was the most reliable method and that other
methods are only an adjunct to clinical
assessment. (22)
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However, these earlier studies were not
based on the modern and improved camera
technology, which, combined with good
technique and computer-aided image
processing, is now known to provide
improved data.
Conclusions
Infrared thermal imaging, also referred to
as thermography, is a reliable noninvasive
technique for imaging skin temperature
distribution. When used in a stable
environment, it has been shown to be useful
in the assessment of tissue viability and
peripheral circulation applied to diabetes
mellitus. It is especially suitable for serial
measurements used in the follow-up of
response to treatment.
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