A New Perspective on the Diagnosis of Septic Arthritis: High-Resolution Thermal Imaging.

Abstract

An increase in temperature in an area suspected of septic arthritis is a clinically important finding. The aim of this study is to evaluate temperature changes in septic arthritis with a high-resolution thermal camera. A total of 49 patients, who were evaluated with a prediagnosis of arthritis (septic or non-septic), were included in this study. A temperature increase in the knee with suspected septic arthritis was evaluated by using thermal imaging and compared with the opposite-side joint. Then, in order to confirm the diagnosis, a culture was taken using routine intra-articular aspiration. The thermal measurements were compared in 15 patients with septic arthritis and 34 patients with non-septic arthritis. The mean temperature was 37.93 °C in the septic group, while it was 36.79 °C in the non-septic group (p < 0.000 *). The mean temperature difference in both joints was 3.40 °C in the septic group, while it was 0.94 °C in the non-septic group (p < 0.000 *). While the mean temperature was 37.10 °C in the group with septic arthritis, it was measured to be 35.89 °C in the group non-septic arthritis (p < 0.020). A very strong positive correlation was found between the difference in the mean temperatures of both groups and the values of the hottest and coldest points (r = 0.960, r = 0.902). In the diagnosis of septic arthritis, thermal imagers can be used as a non-invasive diagnostic tool. A quantitative value can be obtained to indicate to a local temperature increase. In future studies, specially designed thermal devices can be developed for septic arthritis.