Diagnostic Accuracy of Ankle-Brachial Index and Infrared Thermography: Early Detection and Screening for Lower-Limb Peripheral Vascular Disease

Abstract

Peripheral arterial disease (PAD) is a significant cardiovascular condition characterized by reduced blood flow to the lower extremities and may lead to tissue damage, ulceration, and amputation if not detected early. This study reviews the diagnostic accuracy and clinical value of the ankle-brachial index (ABI) and infrared thermography (IRT) as non-invasive tools for the early detection and screening of lower-limb peripheral arterial disease and tissue stress. ABI is widely used to assess arterial insufficiency, with automated oscillometric measurements demonstrating comparable sensitivity to manual Doppler methods while offering improved specificity and greater ease of use in routine clinical settings. Infrared thermography complements vascular assessment by detecting abnormal temperature patterns and localized thermal changes that may indicate subclinical inflammation and an increased risk of tissue breakdown before visible skin damage occurs. Evidence suggests that significant contralateral temperature differences may serve as an early indicator of inflammatory or ulcerative risk. The combined use of automated ABI and infrared thermography provides a rapid, non-invasive, and complementary approach for identifying both impaired circulation and early tissue abnormalities. Integrating these screening modalities into clinical practice may support earlier intervention, improve diagnostic efficiency, and potentially reduce the risk of serious lower-limb complications, including ulceration and amputation.