Bradley Justin, Rumble Mollie, Wong Jennifer, Yii Ming, Kaminski Michelle R
Department of Podiatry, St Vincent's Hospital Melbourne, Victoria, Australia.
Department of City Futures, City of Stonnington Council, Victoria, Australia.
J Foot Ankle Res. 2025 Sep;18(3):e70059. doi: 10.1002/jfa2.70059.
Dermal temperature differentials between limbs are used to monitor disease progression and support safe withdrawal of immobilisation in Charcot neuro-osteoarthropathy (CNO). Despite the wide clinical use of dermal thermometry, there is a lack of evidence on the optimal temperature stabilisation period after removal of immobilisation devices, such as total contact casts (TCCs). This study aimed to investigate the optimal time period to achieve temperature stabilisation post removal of TCC for assessing dermal temperatures in active CNO.
Over a 2-year period, this within-subjects repeated measures study recruited 12 adults with active CNO treated with TCC from a metropolitan high-risk foot service in Melbourne, Australia. Participants were excluded if they had bilateral CNO, an active foot ulcer, an inflammatory foot condition (e.g., gout), peripheral artery disease or major lower limb amputation. In a temperature-controlled room, dermal temperatures were recorded using an infrared thermometer after removal of TCC and contralateral footwear. Temperatures were recorded at 10-min intervals from baseline to 90 min at 10 anatomical locations on each foot. Paired samples t-tests or Wilcoxon signed-rank tests explored temperature stabilisation at each anatomical site across the 10 time points.
Mean age was 55.1 (SD, 8.9) years, 75.0% were male and 83.3% had type 2 diabetes. All participants had peripheral neuropathy and a large proportion had history of foot ulceration (75.0%). The average duration of CNO was 2.9 (SD, 1.7) months, with most classified as stage 1 (91.7%), affecting the tarsometatarsal joints (58.3%) and midtarsal joints (83.3%). Overall, dermal temperatures had stabilised by 40 min for the Charcot (casted) foot and contralateral (non-casted) foot.
This is the first study to explore the optimal time period to achieve temperature stabilisation when assessing dermal temperatures in active CNO. Forty minutes appears to be an appropriate resting time to reach thermal equilibrium. Although this approach may improve the accuracy of dermal thermometry, the time period may not always be feasible in clinical practice.
肢体间的皮肤温度差异用于监测夏科特神经骨关节病（CNO）的疾病进展，并支持安全解除固定。尽管皮肤温度测量在临床上广泛应用，但对于去除固定装置（如全接触石膏（TCC））后最佳温度稳定期的证据不足。本研究旨在探讨去除TCC后实现温度稳定的最佳时间段，以评估活动性CNO的皮肤温度。
在2年的时间里，这项受试者自身重复测量研究从澳大利亚墨尔本的一个大都市高危足部服务机构招募了12名接受TCC治疗的活动性CNO成年患者。如果患者患有双侧CNO、活动性足部溃疡、炎性足部疾病（如痛风）、外周动脉疾病或主要下肢截肢，则被排除。在温度受控的房间里，去除TCC和对侧鞋类后，使用红外温度计记录皮肤温度。从基线到90分钟，每隔10分钟在每只脚的10个解剖位置记录温度。配对样本t检验或Wilcoxon符号秩检验探讨了10个时间点上每个解剖部位的温度稳定性。
平均年龄为55.1（标准差，8.9）岁，75.0%为男性，83.3%患有2型糖尿病。所有参与者均患有周围神经病变，很大一部分有足部溃疡病史（75.0%）。CNO的平均病程为2.9（标准差，1.7）个月，大多数分类为1期（91.7%），影响跗跖关节（58.3%）和中跗关节（83.3%）。总体而言，夏科特（石膏固定）足和对侧（未石膏固定）足的皮肤温度在40分钟时已稳定。
这是第一项探讨在评估活动性CNO皮肤温度时实现温度稳定的最佳时间段的研究。40分钟似乎是达到热平衡的合适休息时间。尽管这种方法可能会提高皮肤温度测量的准确性，但在临床实践中这个时间段可能并不总是可行的。
