Abstract

Acute limp is a common presenting condition in the paediatric emergency department. There are a number of causes of acute limp that include traumatic injury, infection and malignancy. These causes in young children are not easily distinguished. In this pilot study, an infrared thermographic imaging technique to diagnose acute undifferentiated limp in young children was developed. Following required ethics approval, 30 children (mean age = 5.2 years, standard deviation = 3.3 years) were recruited. The exposed lower limbs of participants were imaged using a high-resolution thermal camera. Using predefined regions of interest (ROI), any skin surface temperature difference between the healthy and affected legs was statistically analysed, with the aim of identifying limp. In all examined ROIs, the median skin surface temperature for the affected limb was higher than that of the healthy limb. The small sample size recruited for each group, however, meant that the statistical tests of significant difference need to be interpreted in this context. Thermal imaging showed potential in helping with the diagnosis of acute limp in children. Repeating a similar study with a larger sample size will be beneficial to establish reproducibility of the results.Graphical abstractA young child with an acute undifferentiated limp undergoes thermal imaging and the follow on image analysis assists the limp diagnosis.

Highlights

  • Acute limp is a common presenting complaint in the paediatric emergency department (ED)

  • This study aimed to explore a unique aspect of medical thermography, with a focus on a paediatric emergency environment

  • Drawing from information presented in the literature, this study aimed to develop and evaluate a method of infrared thermographic imaging to assist diagnosis of acute undifferentiated limp in young children

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Summary

Introduction

Acute limp is a common presenting complaint in the paediatric emergency department (ED). A UK study reported the incidence of a non-traumatic limp as 1.8 in every 1000 children aged under 14 years, but the true incidence representing all limp is much higher [1]. An ‘acute’ limp is defined in a patient presenting with symptoms of recent onset, often in the last 48 hours. An ‘undifferentiated’ limp is not yet specified by clinical diagnosis and requires both physical examination and further investigation to determine the cause of the complaint. University, Sheffield, UK 4 Department of Clinical Surgical Sciences, University of the West.

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