A quantitative index for classification of plantar thermal changes in the diabetic foot

Abstract

One of the main complications caused by diabetes mellitus is the development of diabetic foot, which in turn, can lead to ulcerations. Because ulceration risks are linked to an increase in plantar temperatures, recent approaches analyze thermal changes. These approaches try to identify spatial patterns of temperature that could be characteristic of a diabetic group. However, this is a difficult task since thermal patterns have wide variations resulting on complex classification. Moreover, the measurement of contralateral plantar temperatures is important to determine whether there is an abnormal difference but, this only provides information when thermal changes are asymmetric and in absence of ulceration or amputation. Therefore, in this work is proposed a quantitative index for measuring the thermal change in the plantar region of participants diagnosed diabetes mellitus regards to a reliable reference (control) or regards to the contralateral foot (as usual). Also, a classification of the thermal changes based on a quantitative index is proposed. Such classification demonstrate the wide diversity of spatial distributions in the diabetic foot but also demonstrate that it is possible to identify common characteristics. An automatic process, based on the analysis of plantar angiosomes and image processing, is presented to quantify these thermal changes and to provide valuable information to the medical expert.