Abstract
IntroductionPsoriasis arthritis (PsA) is a chronic inflammatory arthritis of joints of uncertain pathogenesis. PsA may lead to severe disabilities even in the absence of any clinical symptom. Therefore, PsA diagnosis in its early stages is critical.Material and methodsThis study uses Control System theory to model finger skin thermoregulatory processes overlying the hand joint in response to an isometric exercise. The proposed model is based on a homeostatic negative feedback loop characterized by four distinct parameters that describe how the control mechanisms are activated and maintained. Thermal infrared imaging was used to record a total of 280 temperature curves of 14 finger joints for each of 11 PsA patients and 9 healthy controls.Result and conclusionPsA patients presented delayed and prolonged re-warming processes characterized by the undershoot onset after the end of the isometric exercise followed by a faster temperature increase. Region classification on the basis of the model parameters demonstrated that the interphalageal joint region of thumb better discriminates between patients and controls, providing 100% true-positive discrimination for PsA affected regions and 88.89% of correct classification of healthy regions. Even proved over a limited number of subjects, the proposed method may provide useful hints for early differential diagnosis in the IR assessment of PsA disease.
Highlights
Psoriasis arthritis (PsA) is a chronic inflammatory arthritis of joints of uncertain pathogenesis
Result and conclusion: PsA patients presented delayed and prolonged re-warming processes characterized by the undershoot onset after the end of the isometric exercise followed by a faster temperature increase
Region classification on the basis of the model parameters demonstrated that the interphalageal joint region of thumb better discriminates between patients and controls, providing 100% true-positive discrimination for PsA affected regions and 88.89% of correct classification of healthy regions
Summary
Psoriasis arthritis (PsA) is a chronic inflammatory arthritis of joints of uncertain pathogenesis. Isometric exercise was evident to be potentially able to elicit significantly different thermal responses in both healthy and PsA patient groups [12] Such evidence was based on a qualitative study without providing a broad understanding of the complex mechanism underlying thermoregulation malfunctions in this disease [12]. A quantitative evaluation of the cutaneous temperature of the skin overlying the proximal and distal Interphalangeal Joints of PsA patients in both basal conditions and in response to functional (isometric) exercise, could provide a functional indicator of the hypothetical PsA-related thermoregulatory malfunctions of skin overlying joints due to their inflammation providing a mean to assess indirectly PsA disease activity and help its primary diagnosis. Mariotti et al [6,7] proposed a thermoregulatory model based on a homeostatic negative feedback loop characterized by four distinct functional parameters, which describe how thermal control mechanisms are activated and maintained in response to a cold challenge in the percense of RP disease and Varicocele
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