Peripheral arterial disease (PAD) poses a threat of limb amputation and cardiovascular events. However, PAD diagnostic procedure requiring time, cost, and technical skills preclude its application as a screening test in the general population. Although PAD tends to be associated with lower foot skin temperature, none has yet to appreciate its usefulness for diagnosis/screening. We measured foot skin temperatures at the first and fifth metatarsal head and heel areas using noncontact infrared thermometer at the time of ankle brachial pressure index (ABI) measurement and limb arterial ultrasonography in 176 patients (345 legs) in participants. Foot skin temperatures correlated with ABI and showed distinctly lower levels in legs with ultrasound-confirmed arterial stenosis/occlusion and in those with ABI ≤0.90. Receiver operating characteristics analyses revealed that the lowest temperature value of the 3-foot locations had a higher sensitivity than every single location in detecting lower extremity PAD. Diagnostic efficiency for the ABI cutoff of 0.90 showed sensitivity/specificity of 41%/94%, while that for the lowest skin temperature cutoff of 30.8°C showed sensitivity/specificity of 60%/64%. In conclusion, an accurate skin temperature measurement using noncontact handheld infrared skin thermometer could serve as a new, cost-effective screening strategy for earlier diagnosis of PAD.
The value of toe pulse waves in determination of risks for limb amputation and death in patients with peripheral arterial disease and skin ulcers or gangrene