目的:对侧温度差(CTD)是Charcot神经关节病(CNA)治愈的常用标志。我们旨在确定在愈合过程中是否有一致的CTD测量方法以及停止固定的决策过程。
方法:Medline,Scopus,和WebofScience搜索到2022年2月的同行评审研究,使用关键词包括((“关节病”或“骨关节病”或“骨病”或“神经关节病”)和“Charcot”和(“温度”)),它返回了789个结果,不包括重复项。纳入的研究监测了具有活性CNA的CTD,以(i)评估愈合过程;或(ii)协助确定从固定的过渡。
结果:总共有34项研究(n=677名参与者)入围,19项经全篇论文综述后纳入。呈现时的平均CTD在1.6-8.0°C之间变化,没有足够的数据来确定CTD是否与Charcot的严重程度成比例。CTD与基于射线照相或闪烁显像的愈合标志物之间关系的证据取决于所采用的方法。停止固定的阈值CTD范围为<1°C至<2°C。最常见的是<2°C持续2-3次访问。在足休息15分钟后,通常每2-6周使用手持测温法在CNA部位监测温度。设备类型,准确性/可靠性,和环境温度很少报告。
结论:需要对CTD和放射学和放射性示踪剂标志物进行进一步研究,涉及更大的队列。报告测温设备类型时的标准化,准确性和可靠性,脚的休息时间和环境温度的控制是必要的,以促进比较的研究,不同固定干预措施的荟萃分析和评价。本文受版权保护。保留所有权利。
Contralateral temperature difference (CTD) is a frequently used marker of healing in Charcot neuro-osteoarthropathy (CN). We aimed to determine whether there is a consistent approach to CTD measurement during healing and the decision-making process around cessation of immobilisation.
Medline, Scopus, and Web of Science were searched until February 2022 for peer-reviewed studies using keywords, including ((\'arthropathy\' OR \'osteoarthropathy\' OR \'osteopathy\' OR \'
neuroarthropathy\') AND \'Charcot\' AND (\'temperature\')), which returned 789 results excluding duplicates. Included studies monitored CTD in those with active CN to (i) assess the healing process and (ii) assist in determining the transition from immobilisation.
Thirty four studies in total (n = 677 participants) were shortlisted and 19 were included after full paper
review. Average CTD at presentation varied from 1.6 to 8.0°C with insufficient data to determine if CTD was proportional to severity of Charcot. Evidence of a relationship between CTD and radiographic or scintigraphy-based markers of healing varied depending on the methodology employed. Threshold CTD for the cessation of immobilisation ranged from <1°C to <2°C. Most frequently it was <2°C sustained for 2-3 visits. Temperature was monitored typically every 2-6 weeks using handheld thermometry at CN site(s) after resting the feet for 15 min. Device type, accuracy/reliability, and ambient temperature were rarely reported.
Further research on CTD and radiographic and radiotracer markers is needed involving larger cohorts. Standardisation in reporting of thermometry device type, accuracy and reliability, foot resting times, and ambient temperature controls is essential to facilitate the comparison of studies, meta-analysis, and evaluation of different immobilisation interventions.