Medical Infrared Thermography Research Articles

Effects of meridian sinew tuina after identifying the treatment area under ultrasound localization combined with greater and third occipital nerve injections in cervicogenic headache: a randomized controlled trial protocol.

Cervicogenic headache (CEH) is a secondary headache characterized by chronic, unilateral headache. Ultrasound-guided injections of the greater occipital nerve (GON) and the third occipital nerve (TON) are effective in the treatment of CEH, as is meridian sinew tuina for the treatment of CEH, but the evidence of clinical efficacy of combining these two therapies is valid. Therefore, we have designed a randomized controlled trial with the aim of investigating the efficacy and safety of ultrasound localization meridian sinew tuina combined with GON and TON injections for the treatment of CEH. In this study, we enroll 60 patients experiencing CEH. The control group receives ultrasound-guided injections of GON and TON. The intervention group is treated with ultrasound localization meridian sinew tuina combined with the injection of GON and TON. Meridian sinew tuina is performed once a day for 30 min for 3 days. The primary observational index includes the Short-Form of McGill Pain Questionnaire (SF-MPQ). The Secondary outcomes include Cervical Range of Motion (ROM) and Medical Infrared Thermography (MIT). MIT is used to measure the change in skin temperature in the area of the patient's meridian sinew tuina treatment of GON and TON before and after the intervention. There are 5 time points assessed as baseline, day 3, day 15, day 30, and day 60. This study proposes to combine ultrasound-guided injections of GON and TON for the treatment of CEH after identifying the treatment area of meridian sinew tuina under ultrasound localization. Meanwhile, MIT is utilized to provide objective evidence of the efficacy of CEH. ChiCTR2300076128.

Medical Infrared Thermography in Odontogenic Facial Cellulitis as a Clinical Decision Support Tool. A Technical Note.

Background: Odontogenic cellulitis are frequent infections of the head and neck fascial spaces that can sometimes spread and be life-threatening, requiring urgent hospitalization. Early diagnosis of facial cellulitis with diffuse inflammatory process is crucial in patient management but not always obvious in the field. Medical infrared thermography (MIT) is a noninvasive tool increasingly used to evaluate skin temperature maps and delineate inflammatory lesions. Objective: The aim of this work was to evaluate the use of MIT to improve the clinical examination of patients with facial cellulitis. Methods: Image processing work was carried out to highlight the thermal gradient resulting from inflammation linked to infection, in 2 patients with facial cellulitis. Results: In real-time, MIT allowed to precisely locate the inflammatory focus linked to cellulitis with no propagation to danger areas such as infraorbital space or around pharyngeal axis. Conclusions: Here, we show the first cases using MIT as a powerful complementary tool in the clinical evaluation of patients with facial cellulitis. Significance: This technology could help optimize the hospitalization decision through a facilitated assessment of infection spread in head and neck tissues and helping to incision for drainage.

Medical infrared thermography as hidradenitis suppurativa diagnostic tool: literature review

Hidradenitis suppurativa (HS) is a rare, chronic, inflammatory skin disease that has a strong impact on the quality of life. Medical infrared thermography (MIT) is a non-invasive imaging method that could be used for evaluation of skin inflammation, which is an important biomarker in HS. We performed a comprehensive review of the literature to verify the possibilities of using MIT for HS. Key words “hidradenitis suppurativa”, “acne inversa” and “thermography” were used for PubMed, Embase and Scopus literature analysis and in total four articles fulfilled the inclusion criteria. The inflamed areas have shown the increase in temperature (34.3°C) and after the removal of lesions the temperature has become similar to the healthy skin sites. The margins of the inflammatory lesions identified by MIT were used in the surgical treatment. Also, MIT was used in combination with other imaging tests for inflammation evaluation. Thermography is an advantageous tool to detect inflammation and to secure the success of surgical treatment.

Review of imaging technologies used in Hidradenitis Suppurativa.

Until recently, clinical assessment with manual palpation of the HS lesions was the primary means to detect HS lesions and their borders. In the past decade, there has been increased application of imaging technologies to HS patients, and it is reported that manual palpation consistently underestimates HS. Of the technologies, ultrasound (US) imaging has been the most efficacious and well-studied. In the present review, we will discuss the various imaging modalities that aid in detecting, managing, and treating HS. Non-invasive HS imaging technologies including ultrasound (US) imaging, magnetic resonance imaging (MRI), medical infrared thermography (MIT), positron emission topography (PET), and computed tomography (CT) were reviewed and compared through a review of the literature. PubMed, Google, and Google Scholar were utilized. Of the 4 HS technologies reviewed, US imaging and MRI are the most established and useful non-invasive modalities utilized in HS patients. However, MIT may have potential to aid in the pre-operative and intra-operative surgical excision of HS lesions. For imaging HS lesions, US imaging is the most well-characterized and has the greatest range of use, while MRI has a role in severe, anogenital HS lesions. MIT of HS lesions is a novel application and merits attention.

Long-Wave Medical Infrared Thermography: A Clinical Biomarker of Inflammation in Hidradenitis Suppurativa/Acne Inversa

Background: A more reliable classification of skin inflammation and severity of active disease results from ultrasound sonography and the new hidradenitis suppurativa/acne inversa (HS) classification system IHS4. However, an objective assessment of skin inflammation in a continuous mode is still the ultimate goal. Long-wave medical infrared thermography (MIT) may offer a blood flow and temperature differential assessment in inflammatory conditions. Objective: To evaluate the application of MIT in HS. Methods: Standardized photography of the areas involved or been candidates for HS involvement was performed and MIT pictures were taken simultaneously and superimposed on the photographs of 18 patients (11 female, 7 male, median age 38.75 years [95% confidence interval 28.5 and 51 years], Hurley score I 5.6%, Hurley score II 38.9%, and Hurley score III 55.5%). A modification of the Otsu’s method facilitated the automatic lesion segmentation from the background, depicting the inflammation area. Moreover, MIT was administered in real-time mode during radical HS surgery. Results: A 1°C temperature difference from a corresponding symmetric body region was indicative of inflammation. MIT figures detected a gradual increase of skin temperature from 33.0°C in healthy skin on average to 35.0–36.6°C at the center of inflamma tory lesions in the axilla and to 35.4–36.9°C at the center of inflammation in the groin area. Real-time MIT assessment enabled the definition of the margins and depth of the surgical intervention during the procedure. Conclusion: MIT is a promising tool for the detection of inflammation severity in HS lesions and can be used as a clinical biomarker in evaluation studies of medical and surgical HS treatment.

Innovative Use of Medical Infrared Thermography to Evaluate Adhesive Properties of Two Buprenorphine Transdermal Patch Formulations in a Single Dose Adhesion Performance Study

An innovative approach for the assessment of transdermal patches adherence to the skin was developed and applied post-hoc to supportive imaging data collected in an open label, two-period, two-sequence, two-way crossover, controlled, randomized, single dose study to assess adhesion performance of two buprenorphine formulations (generic versus originator), applied topically to healthy male and female volunteers. The technology used for data acquisition is called Medical Infrared Thermography (MIT), a non-invasive, non-radiating imaging technique for surface temperature mapping. The use of this technology in an adhesion performance study was based on the rationale that the surface of a transdermal patch reaches a temperature in equilibrium with that of the body area where it is applied and whenever a discontinuity between skin and patch exists, the transmission of thermic energy to the surface of the transdermal patch changes. In case air is interposed, the transmission is minimal so any cases of patch lift-off from skin become visible on thermograms. The thermograms were acquired in standardized conditions but were initially intended only as supportive imaging technique, while the primary adhesion performance data was acquired through the standard approach of visual examination coupled with manual markings. In this article we further demonstrate the value of the acquired thermograms as main adhesion assessment tools, used in conjuncture with an in-house validated image processing software for the actual quantification of percentages of detachment. This novel approach for automated and unbiased analysis of adhesion performance was shown to be highly reliable and reproducible, attributes that recommend it for future use as primary adhesion assessment tool pending completion of full method validation.

Are Clinical Symptoms Of Running Overuse Injuries Associated With Thermographic Response? A Proof-of-concept Study

Medical infrared thermography (MIT), a non-radiating imaging technology, detects changes in skin temperature. Musculoskeletal injuries result in blood flow changes which may produce patterns of associated changes in skin temperature that can be visually detected by MIT. PURPOSE: To determine if clinical symptoms of distal lower extremity overuse injuries in runners are associated with visually detectible changes in MIT. METHODS: 29 competitive distance runners (age 18-25y, running >25 miles per week) enrolled and participated. Once weekly, runners reported to lab for MIT photos of bilateral lower limbs taken with an infrared camera. Prior to MIT, runners acclimatized to lab conditions for 15 minutes and the camera was calibrated to the room temperature and humidity. A modified Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire was used for athlete-reported musculoskeletal symptoms and problems. MIT photos and OSTRC scores were obtained on a weekly basis for 8 weeks. Runners’ photos were grouped into those with no reports of any lower extremity problems (Controls: OSTRC = 0, n=5); and those with reports of significant lower extremity problems (Injured: OSTRC >50, n=7). Photos from each group were placed into an online viewer and evaluated by 7 blinded clinicians. For the injured group, a photo from the week of the highest reported OSTRC score was paired with a baseline (OSTRC <25) photo. For the control group, two uninjured photos were paired. The reference photo for each pair was labeled. The order of photos (control vs. injured) was randomized and reviewers were not provided the number of included injured runners. Clinicians visually inspected 12 image pairs and decided whether or not the photo suggested a lower extremity problem existed. Diagnostic accuracy statistics were computed for each evaluator. RESULTS: The median (interquartile range) for the seven evaluators were: sensitivity=0.43 (0.29), specificity=0.60 (0.2), positive likelihood ratio=1.43 (0.0), negative likelihood ratio=0.71 (0.18). CONCLUSIONS: Low diagnostic accuracy and considerable inter-rater variability suggests evaluator training of MIT interpretation is necessary to accurately confirm or disconfirm presence of injury based on MIT findings.

The use of medical infrared thermography in the detection of tendinopathy: a systematic review

Background: Tendinopathy is a common sports-related injury. A variety of assessment tools are available but none are diagnostic. We aimed to evaluate the utility of Medical Infrared Thermography (MIT) as a tendinopathy detection tool.Objectives: To guide clinical assessment paradigms by reviewing and critically evaluating the application of MIT for detecting and staging tendinopathy.Methods: PubMed, Web of Science, OVID and Cochrane Library were searched for papers evaluating the use of MIT for tendinopathy detection, published in English from inception to March 2015. Reference lists and citing articles were also searched. Six of 748 studies fulfilled the inclusion criteria and were quality assessed.Results: There is strong evidence for the role of MIT in the detection of chronic lateral elbow epicondylalgia and limited for patellar tendinopathy, with statistically significant side to side temperature differences when comparing injured to non-injured limbs, characterised by the presence of ‘hot spots’ over a clinically diagnosed tendinopathy. However, MIT of rotator cuff tendinopathy shows no significant difference between injured and non-injured. No work was found on Achilles tendinopathy, plantar fasciitis, gluteal or wrist tendinopathy.Conclusion: The available evidence suggests a role for MIT in the detection of lateral epicondylitis and patellar tendinopathy, however the utility for grading pathology or staging recovery have not been studied in sufficient detail to clarify the relationship between thermographic measurement and severity. There was inconclusive evidence to support the role of MIT in the detection of rotator cuff and various other tendinopathies, and this research is therefore warranted.

An Overview of Recent Application of Medical Infrared Thermography in Sports Medicine in Austria

Medical infrared thermography (MIT) is used for analyzing physiological functions related to skin temperature. Technological advances have made MIT a reliable medical measurement tool. This paper provides an overview of MIT’s technical requirements and usefulness in sports medicine, with a special focus on overuse and traumatic knee injuries. Case studies are used to illustrate the clinical applicability and limitations of MIT. It is concluded that MIT is a non-invasive, non-radiating, low cost detection tool which should be applied for pre-scanning athletes in sports medicine.