Abstract
Juvenile idiopathic arthritis (JIA) causes inflammation of the joints, and it is frequently associated with their pain and stiffness. Its timely diagnosis is important to avoid its progressive damage to the bones and cartilage. Increases in the joint’s temperature and redness could be indicators of active JIA, hence their accurate quantification could assist with diagnosis. Thermal and visual images of the knees in 20 JIA participants (age: mean = 11.2 years, standard deviation = 2.3 years) were studied. The median temperature of knees with active inflammation was 3.198% higher than that of inactive knees. This difference, examined by a Wilcoxon signed-rank test, was statistically significant (p = 0.0078). In six out of the eight participants who had one active inflamed knee, thermal imaging identified the corresponding knee as warmer. In 16 out of 20 participants, the knee identified as warmer by thermal imaging was also identified as having a greater colour change by visual imaging as compared to their respective reference regions. The devised methods could accurately quantify the colour and temperature of the knees. It was concluded that thermal and visual imaging methods can be valuable in examining JIA. Further studies involving a larger number of participants and more detailed explorations would be needed prior to clinical application.
Highlights
Juvenile idiopathic arthritis (JIA) is a broad term used to describe various forms of chronic arthritis that manifest before the age of 16 years and persist for more than 6 weeks [1]
Individuals were excluded if they were aged 4 years or under (the paediatric gait arms legs and spine tool for musculoskeletal examination is validated for school-aged children), had any chronic or active infection, had any recent fracture, exhibited the presence of any other diagnosis that could result in arthritis, or were non-English speaking
To aid the interpretation of assessment the results,ofthe participants three diagnostic groupings according to clinician whether the kneeswere weredivided inflamedinto or not at the time of groupings according to clinician assessment of whether the knees were inflamed or not at the time of thermal and visual imaging
Summary
Juvenile idiopathic arthritis (JIA) is a broad term used to describe various forms of chronic arthritis that manifest before the age of 16 years and persist for more than 6 weeks [1]. The current diagnosis of JIA, and ongoing monitoring for flares of active arthritis, rests on the clinician examination of joints by the visual assessment of joint swelling and restricted movement, and touch to assess for joint warmth, swelling and to elicit joint tenderness [10] This subjective method of detecting arthritis has inherent limitations that may result in unwanted diagnostic delay. The thermal imaging of joint inflammation has potential for providing a non-invasive, portable and inexpensive addition to the currently available tools as it can accurately quantify temperature, which in turn may assist with the diagnosis, monitoring of disease progression and response to medical treatment. Thermal imaging could be performed more frequently than invasive measures (e.g., blood testing) or expensive CE-MRI imaging in children and young people to help confirm a diagnosis of JIA and track the disease progression, aiding more timely intervention than currently may be possible. The methodology is explained and the results are described
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