Armstrong D G, Lavery L A, Liswood P J, Todd W F, Tredwell J A
Department of Orthopaedics, University of Texas Health Science Center, Antonio 78284-7776, USA.
Phys Ther. 1997 Feb;77(2):169-75; discussion 176-7. doi: 10.1093/ptj/77.2.169.
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.
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).
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.
There were differences in skin temperature between the affected foot and the contralateral (i.e., nonaffected) foot among the patients with Characot's arthropathy (8.3 degrees F) and the patients with neuropathic ulcers (5.6 degrees 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 degrees +/- 1.2 degrees F versus 82.5 degrees +/- 2.9 degrees F) at the clinic visit immediately preceding reinjury.
The data suggest that monitoring of the corresponding contralateral foot site may provide clinical information before other clinical signs of injury can be identified.
本研究的目的是比较无症状性周围感觉神经病变患者、神经性溃疡患者和夏科氏关节病患者的皮肤温度，并将对侧肢体作为对照。
回顾性地将143例糖尿病患者分为三组：无症状感觉神经病变患者（n = 78）、神经性足部溃疡患者（n = 44）和神经性骨折（夏科氏关节病）患者（n = 21）。
我们在最初确诊病情时以及随后平均22.1个月（标准差 = 6.4）的临床随访中，使用便携式手持红外皮肤温度探头评估研究对象的皮肤温度。测量对侧足部的皮肤温度作为对照。
夏科氏关节病患者（8.3华氏度）和神经性溃疡患者（5.6华氏度）患侧足部与对侧（即未受影响）足部的皮肤温度存在差异，无症状感觉神经病变患者之间未发现差异。5例神经性溃疡患者在初次愈合后平均12.2个月（标准差 = 6.4）出现溃疡复发，在复发前的临床就诊时皮肤温度相应升高（损伤前即刻就诊时为89.6华氏度±1.2华氏度，而之前为82.5华氏度±2.9华氏度）。
数据表明，在能够识别其他损伤临床体征之前，监测相应的对侧足部部位可能会提供临床信息。
