Thermometry remains a cornerstone in the detection and monitoring of Charcot neuro-osteoarthropathy (CNO)—a frequently silent, yet limb-threatening complication of diabetes. But what if we could go deeper than skin-level heat?
A new study by Eleftheriadou et al., published online in Technology in Wound Care, explores the reliability of microwave radiometry (MWR) as a tool for internal tissue temperature measurement in the diabetic foot—especially in patients with active Charcot.
👉 Full article: https://doi.org/10.1177/15347346251329733
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Study Snapshot
- Participants: 9 patients with active Charcot foot, 5 with diabetes but no CNO
- Comparison: Standard infrared thermometry vs. MWR sensors of different sizes (0.8 cm, 2 cm, 5 cm)
- Follow-up: Median 67 weeks
- Endpoint: Agreement between temperature modalities and predictive value for Charcot recurrence
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Key Findings
- MWR 0.8 (shallow penetration): Excellent agreement with infrared thermometry→ Mean difference: 0.034 °C (P = .676)
- MWR 2 and MWR 5 (deeper sensors): Significantly lower readings than infrared→ Mean differences: −0.323°C and −0.315°C, respectively (P < .001 and P = .002)
- Clinical Decisions: Using MWR instead of infrared would have changed offloading decisions for only 1 of 9 patients
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Implications for Clinical Practice
- Infrared thermometry remains highly reliable—especially when assessing superficial inflammation
- MWR may offer a future pathway for detecting deeper inflammation or “subclinical simmering,” but further validation is needed
- When used in tandem, MWR could add a second dimension to thermometry: one that reaches past the skin into deeper soft tissues and bone
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Monitoring Remission and Reactivation
Reactivation occurred in 3 patients within 21–65 weeks post-offloading. This underlines the longitudinal value of thermal surveillance in Charcot care—and the potential for MWR to one day help us catch “reflaring” earlier, especially when bone and joint inflammation precede skin changes.
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Bottom Line
MWR 0.8 tracks closely with traditional infrared thermometry, making it a valid superficial tool. Larger sensors show promise for future deep-tissue surveillance—but today’s best evidence still supports infrared thermometry as the frontline monitor in Charcot foot.
Citation:
Eleftheriadou I, Tentolouris A, Tentolouris N et al. “Reliability of Microwave Radiometry for the Assessment of Charcot Foot.” Technol Wound Care. 2025. https://doi.org/10.1177/15347346251329733
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