Podium – Scan Feet – Save Lives

Podium – Scan Feet – Save Lives

Using Foot Temperature To Assess Foot Health

Easy control and effective use

The Podium System is made for ease of use, achieving top-quality foot scans every time.

Central Patient Data Access

Podium provides a central hub for all your patients’ scans and questionnaire answers which can be remotely accessed.

Qualitative and Quantitative data

The Podium App includes questions on patients’ symptoms and history plus a note-taking feature to enhance future review and treatment pathway monitoring.

Clear Organised Data Presentation

Podium System data presentation options allow the clinician and patient to clearly visualise current and historic foot health data, incentivising patients to continue their self-care pathways.

Portable for Remote Use

The Podium Device weighs only 3kg enabling simple transportation for point-of-care patient monitoring. Scans can be taken remotely for later automatic uploading to the Podium Portal.

Accurate and Consistent

Accurate and consistent technology allows objective evaluation of foot health by all health care professionals supporting multidisciplinary teams and remote review and assessment.

Using Foot Temperature To Assess Foot Health

Podium Device

A lightweight and robust thermography scanner for the plantar foot:

  • Intuitive thermal images
  • Left/right thermal symmetry comparison histogram analysis
  • Standardised photographs that visualise pressure areas
  • Highly portable in convenient carrying case

Podium App

Running on an industry-standard tablet, the Podium App acts as the primary information input system for patient scans:

  • Drives the Podium Device
  • Displays the thermal scans & photographs
  • Customisable patient questionnaire
  • Patient scans at multiple clinic episodes
  • Patient notes facility
  • Automatically buffers session and uploads to Podium Portal when wifi connection available

Podium Portal

The Podium Portal provides a window into the Podium data repository for organisations and individual clinicians:

  • Review new and historical patient information
  • Access for multi-multidisciplinary support teams
  • Track, review & intervene in patient treatment pathways
  • PDF exports to centralised patient administration systems
  • Print, export & share information
  • Patient & clinician administration

Podium Deployment

Virtual Healthcare: Bring podiatry, diabetic, renal vascular, and other teams together – digitally

  • Displays accurate thermal and white light images
  • Enables all MDT members to view patient records remotely via the portal
  • Helps to make the referral process quicker and more efficient to other specialties

Virtual Healthcare: Patient tracking system

  • The Podium Portal enables multidisciplinary team members to view scans and clinic notes remotely
  • See where and when patients were last assessed, and by whom
  • Check for early signs of inflammation
  • Additional measure to support clinical assessment
  • Monitor progress of pathology or current interventions
  • Compare the progress of different treatments
  • Aid in decision making

Increase Healthcare Capacity

  • Provides additional information for management decisions in between face to face clinic episodes:
    • thermal image – temperature information
    • histogram analysis – symmetry information
    • visual image – pressure, foreign bodies, skin cracks, appearance
  • Enables monitoring of ulcers with consistent and comparable images
  • Reduce the burden on overbooked or currently reduced clinics
  • Scanning can be performed by patients or non-clinical staff

Digital Community Care

  • Highly portable in convenient carrying case
  • Help increase community patient management
  • Monitor at risk patients remotely and more often through digital imaging
  • Scan patients at multiple clinic episodes
  • Review concerning signs in the multidisciplinary teams virtually
  • Enable shared decision-making with community and hospital professionals
  • Provide support and informed advice to colleagues remotely

Increase Patient Involvement

  • Involve patients in their own care
  • View images with patients: explain and show effect of interventions
  • Empower patients to monitor their feet and improve self-care
  • Improve compliance, using Podium images

Foot Thermography Background Information 

  • Foot temperature assessment – a review – normal foot temperature, 4 approaches to identify problems, examples, literature references PDF poster
  • An introduction to foot temperature assessment – why, what and how PowerPoint slides
  • Thermography of the diabetic foot – a PDF white paper on how micro-angiopathy, macro-angiopathy, and neuropathy appear in a plantar foot thermal image
  • Interpreting Podium foot scans How-to Guide
  • Video – How temperature assessment can inform patient care – a 37 minutes, MP4 video
  • Audio – Podium, the background story. Interview on UK Health Radio – The Diabetes Show 50 minutes, MP3 audio
Key Features in Thermal Assessment

The Colour Scale 

  • The colour scale must be interpreted
  • Absolute scale:
    • a fixed scale with the same range for all thermograms (here: 18℃ to 35℃)
    • advantage: same for all thermograms so different scans can be directly compared
    • disadvantage: contrast of colours may be low if foot has a narrow range of temperatures only
  • Dynamic scale:
    • colours are optimised for temperature range of current image (here 16℃ to 27℃)
    • advantage: high contrast, easy to spot small differences in temperature
    • disadvantage: colours can mislead when comparing scans: same colour ≠ same temperature

It is important to note that a contact making device such as Podium is not thermometric, i.e. it does not measure the absolute temperature of the foot. On contact with the thermal sheet the foot cools (if the sheet is colder than the foot) or warms (if it is warmer). As a result the absolute foot temperature changes. This is often advantageous, e.g. when cooling provides a mild “cold stress” that can serve to highlight areas of inflammation. Relative temperature patterns are thus preserved or emphasised which may be helpful when interpreting the resulting thermograms.

Two different colour scales

The Histogram

  • Shows the distribution of temperatures in a thermogram
  • Sorts image pixels with the same temperature into “bins”
  • Each bin is represented by a horizontal line
  • The longer the line, the bigger the area of that temperature
  • Two histograms are shown side by side:
    • one for the left foot
    • one for the right foot
    • allows assessment of left/right temperature symmetry (see further below)

As outlined above Podium thermograms are non-thermometric by design. The numbers on the histogram scale are therefore provided as relative indications and do not represent absolute temperature values.

Image of a thermal histogram

The Healthy Foot

  • Plantar foot temperature of healthy people is characterised by:
    • medial arch being between 0 to 7 warmer than the toes
    • left-right (contralateral) mirror-symmetry better than 1.8 (>2.2 is frequently seen as a warning sign)
    • the 2nd to 5th toe have approximately the same temperature
    • there are no hot spots
    • the average foot temperature is around 26 at the toes and 29 at the medial arch

The image shows the average plantar foot temperature of 103 healthy subjects who were resting at 22℃ for 10 minutes after taking their socks and shoes off. Reproduced from Kluwe B., Early detection of diabetic foot ulcers using thermal imaging, PhD Thesis, University of South Wales, July 2018

The normal foot: average and standard deviation

Thermal Variability

  • Healthy feet are thermally symmetrical but different between individuals and over time
  • The lowest variation, i.e. the most stable temperature region, is the medial arch
  • The most variable parts are the toes and the heel

The image shows the variation of temperatures in the 103 healthy individuals within a 1 standard deviation interval. It is noticeable that the temperature at the toes is far more variable between individuals than that of the medial arch. Reproduced from Kluwe B., Early detection of diabetic foot ulcers using thermal imaging, PhD Thesis, University of South Wales, July 2018

Variability in foot temperature

Thermal Symmetry

  • Healthy feet are thermally highly symmetrical
  • Asymmetry may be an early sign of pathology
  • May be useful to pick up early signs of pathology
  • Additional measure to support clinical assessment
  • Provides an objective indicator of inflammation

The figure shows a histogram of the left-right differences at 33 distinct points in the feet of 103 healthy subjects (resulting in 3,399 data points). The width of the interquartile range (IQR) is 0.9℃, i.e. 50% of all aspects in one foot differ by less than 0.45℃ from those of the other foot, 99% less than 1.8℃. Reproduced from Macdonald A., Petrova N. et al.

Foot symmetry graph