Thermography In Patients Research Articles

Plantar Thermography in High-Risk Patients With Diabetes Mellitus Compared to Nondiabetic Individuals.

Diabetic foot (DF) is one of the most devastating complications of diabetes mellitus (DM). Infrared thermography has been studied for its potential in early diagnosis and preventive measures against DF ulcers, although its role in the management and prevention of DF complications remains uncertain. The objective of this study was to determine the average temperatures of different points of the plantar foot using infrared thermography in patients with DM and history of DF (DFa group, at the highest risk of developing foot ulcers) and compare them to people without DM (NoDM group). One hundred and twenty-three feet were included, 63 of them belonged to DFa Group and the other 60 to NoDM Group. The average temperature in the NoDM Group was 27.4 (26.3-28.5) versus 28.6 (26.8-30.3) in the DFa Group (p = .002). There were differences between both groups in temperatures at the metatarsal heads and heels, but not in the arch. Average foot temperatures did not relate to sex, ankle-brachial index, and age, and had a mild correlation with daily temperature (Spearman 0.51, p < .001). Data provided in our study could be useful in establishing a parameter of normal temperatures for high-risk patients. This could serve as a foundational framework for future research and provide reference values, not only for preventative purposes, as commonly addressed in most studies, but also to assess the applicability of thermography in clinical scenarios particularly when one foot cannot serve as a reference, suspected osteomyelitis of the remaining bone, or instances of increased temperature in specific areas which may necessitate adjustments to the insoles in secondary prevention.

Foot Temperature by Infrared Thermography in Patients with Peripheral Artery Disease before and after Structured Home-Based Exercise: A Gender-Based Observational Study.

Decreased arterial perfusion is a typical condition of patients with peripheral artery disease (PAD), with the microvascular picture particularly present among women. This observational study aimed to detect foot perfusion changes by infrared thermography (IRT) after a home-based exercise program in both sexes. A total of 76 PAD patients with claudication (72 ± 4 years; 52 males) were enrolled in a structured in-home exercise program composed of two daily 8 min interval walking sessions (1:1 walk:rest ratio) with progressively increasing speed. Outcome measures collected at baseline (T0) and at each hospital visit after 5 weeks, 12 weeks and 20 weeks included foot temperature measured by IRT (anterior tibial, posterior tibial, dorsalis pedis and arcuate artery regions), ankle brachial index and the 6 min walking test. After 20 weeks, foot temperature in both limbs showed a significant increasing trend, with a mean variation of 1.3 °C for the more impaired limb and 0.9 °C for the contralateral limb (t = 8.88, p < 0.001 and t = 5.36; p < 0.001, respectively), with significant changes occurring after 5 weeks of training. The sex-oriented analysis did not highlight any significant difference, with an improvement of mean foot temperature of 1.5 ± 0.6 °C in females versus 1.2 ± 0.5 °C in males (p = 0.42). Ankle brachial index and performance also significantly improved over time (p < 0.001) without gender differences. In patients with PAD, a structured low-intensity exercise program significantly improved foot temperature and exercise capacity without any sex-related difference.

A novel technique proposition for determining the resection margins in lung resection by using a thermal camera.

Determination of resection margins is very important in anatomical lung resections for both oncologic outcomes and postoperative complications. Absence of intersegmental plans naturally in segmentectomy surgeries and presence of incomplete fissure variationally in pulmonary lobectomy procedures constitute a challenge for surgeons in determining resection margins. Thoracic surgeons can prefer various techniques such as inflation deflation method, indocyanine green imaging, and three-dimensional segment modeling to cope with this problem. These techniques have some disadvantages such as high cost, the necessity of intravenous drug administration, need for an additional imaging system and ineffectiveness due to emphysema, anthracotic lung surface or interalveolar pores. Here we studied an alternative method for the solution of these disadvantages and aimed to demonstrate the correctness of a hypothesis based on detecting the cooling of the ischemic lung portion by a thermal camera after dividing the related pulmonary artery. We planned determining margins of resection with a thermal camera in patients scheduled for pulmonary lobectomy or segmentectomy. We made some measurements and mapping with a thermal camera before and after the dividing of pulmonary artery of related lobe or segment then processed the images taken with a software on the computer. We detected a significant decrease in temperature in the ischemic lung area and demonstrated mapping the demarcation line between ischemic and perfused areas effectively by thermography in a total of 32 patients underwent lung resection. Pulmonary resection margins can be detected effectively by thermography in patients.

Knee skin temperature response of patients with bilateral patellofemoral syndrome before and after heat and cold stress

Patellofemoral Pain Syndrome is characterized by the presence of pain in the front area of the knee, which occurs when performing common activities such as climbing stairs, and bending the knees, among others. The objective of this research was to evaluate the detection capability of infrared thermography in patients with Patellofemoral Pain Syndrome, in the baseline state, as well as after the application of thermal stress. The investigation was conducted in 48 patients, who were subdivided into four groups (n = 12). Two subgroups were healthy patients and two with Patellofemoral Pain Syndrome. For the diagnosis of the syndrome, a manual evaluation was performed using the Zohlen test and Q angle measurement. Subsequently, cold stress was applied for 10 min to a healthy subgroup and an experimental subgroup. The remaining two subgroups were subjected to heat stress for 15 min. Thermographic images of the lower extremities were acquired at seven time points, at baseline, immediately after application of thermal stress and then every 3 min until 15 min were completed. It was observed that patients presented Patellofemoral Pain Syndrome bilaterally. After statistical analysis, it was found that there were no significant differences in baseline temperature between the groups. However, for heat stress, a higher temperature was observed in the group with Patellofemoral Pain Syndrome (p < 0.05) in the recovery period, and in the case of cold stress, only a lower temperature in the left knee immediately after the application. In conclusion, it is not possible to detect patellofemoral syndrome bilaterally in the baseline state by thermography and neither is it evident in cold stress. However, after heat stress, thermal recovery is lower for the PFPS group, so it would be susceptible to detection.

Comparison of the Clinical Effectiveness Between Infrared Thermography and Electrophysiology Tests in Spinal Intradural Extramedullary Schwannoma.

Subjective pain is experienced differently by each patient; therefore, modalities that can objectify subjective symptoms are useful. Electrophysiology tests and infrared (IR) thermography can present subjective symptoms in an objective manner. This study aimed to compare the effectiveness of electrophysiology tests and IR thermography in patients with intradural extramedullary (IDEM) schwannoma and statistically analyze the results to verify the positive relationship between the subjective neurologic symptoms and test results. We retrospectively analyzed the data from 23 patients, pathologically confirmed to have IDEM spinal schwannoma after surgery between January 2012 and December 2020. All patients were preoperatively examined using IR thermography and an electrophysiology test. IR thermography was conducted again week after operation. The IR thermography results were classified as either positive or negative. Radiculopathy symptoms were reported in 16 cases and myelopathy in 7 cases. Among the radiculopathy patients, 9 out of 16 (56.2%) showed positive electrophysiology test results. Among the myelopathy patients, 2 out of 7 (28.5%) showed positive electrophysiology test results. In the radiculopathy group, 15 out of 16 (93.7%) patients showed positive IR thermography results. In the myelopathy group, 2 out of 7 (28.5%) patients showed positive IR thermography results. The correlation between the IR thermography and electrophysiology test was analyzed. In the radiculopathy group, positive electrophysiology test result was obtained in 8 out of 15 (53.5%) patients with positive IR thermography result. In patients with IDEM schwannoma presenting radiculopathy symptoms, IR thermography is a complementary tool to objectify the neurological symptoms.

Musculoskeletal applications of infrared thermography on back and neck syndromes: a systematic review.

Thermography is a noninvasive method to detect temperature changes on or near the surface of the body. Despite its utility has not yet been fully verified, it may be used as a complementary method to screening and/or monitoring treatment effectiveness. This systematic review evaluates the role of infrared thermography as a helpful outcome measure tool in subjects with back and neck syndromes. A literature search was conducted across the National Library of Medicine (MEDLINE), Web of Science and Scopus databases for studies that evaluated the role of infrared thermography as a helpful outcome measure tool in subjects with back and neck syndromes. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The search strategy and selection criteria yielded 812 articles. From these, 268 duplicates were removed, and only 16 were in line with the aim of this review. Ultimately, only seven precisely fulfilled the inclusion and exclusion criteria and were included in the review. According to the articles reviewed, thermography seems to give an objective notion of change in inflammatory activity, which can corroborate the usefulness of treatment or the improvement/worsening of the patient's symptoms. The overall quality of research was uneven in the study design, endpoint measures, and sample characteristics. The number of high-quality studies of the role of infrared thermography in patients with back and neck syndromes remains limited. More than a diagnostic tool, thermography can be an objective tool for monitoring the effectiveness of treatment by identifying deviations from a healthy state.

К юбилею Адольфа Исааковича Бухмана

Adolf I. Bukhman, one of the founding fathers of Russian roentgenology, was celebrating his 90th anniversary on September 30, 2018. A.I. Bukhman has developed, modified, and launched into clinical practice 27 diagnostic and radiation therapy procedures (lymphography of the thyroid and parathyroid glands, electroroentgenography and thermography in patients with endocrine disorders, bone age assessment tables taking into account developmental acceleration, etc.). He was first to address the issue skeletal mineralization with respect to age, characterize the condition of soft tissues in patients with diabetes mellitus and acromegaly, and develop radiation therapy to manage angiopathies, arthropathies, and trophic ulcers. A.I. Bukhman has significantly contributed to the development of mammography. He was first to publish the first studies on using mammography in patients with endocrine disorders in the USSR. Adolf Isaakovich has also been the first roentgenologist worldwide who has described fluoromammography. Adolf Isaakovich has earned love and respect from his colleagues. On his anniversary, the staff of the National Medical Research Center for Endocrinology are wishing Adolf Isaakovich sound health, many fruitful years for the benefit of Russian roentgenology and endocrinology, success in future endeavors, wellbeing, vivacity and fortitude.

On the Occasion of the Anniversary of Adolf I. Bukhman

Adolf I. Bukhman, one of the founding fathers of Russian roentgenology, was celebrating his 90th anniversary on September 30, 2018.&#x0D; A.I. Bukhman has developed, modified, and launched into clinical practice 27 diagnostic and radiation therapy procedures (lymphography of the thyroid and parathyroid glands, electroroentgenography and thermography in patients with endocrine disorders, bone age assessment tables taking into account developmental acceleration, etc.). He was first to address the issue skeletal mineralization with respect to age, characterize the condition of soft tissues in patients with diabetes mellitus and acromegaly, and develop radiation therapy to manage angiopathies, arthropathies, and trophic ulcers. A.I. Bukhman has significantly contributed to the development of mammography. He was first to publish the first studies on using mammography in patients with endocrine disorders in the USSR. Adolf Isaakovich has also been the first roentgenologist worldwide who has described fluoromammography.&#x0D; Adolf Isaakovich has earned love and respect from his colleagues. On his anniversary, the staff of the National Medical Research Center for Endocrinology are wishing Adolf Isaakovich sound health, many fruitful years for the benefit of Russian roentgenology and endocrinology, success in future endeavors, wellbeing, vivacity and fortitude.

A Multicenter Study of the Validity and Reliability of Responses to Hand Cold Challenge as Measured by Laser Speckle Contrast Imaging and Thermography: Outcome Measures for Systemic Sclerosis-Related Raynaud's Phenomenon.

ObjectiveReliable and objective outcome measures to facilitate clinical trials of novel treatments for systemic sclerosis (SSc)–related Raynaud's phenomenon (RP) are badly needed. Laser speckle contrast imaging (LSCI) and thermography are noninvasive measures of perfusion that have shown excellent potential. This multicenter study was undertaken to determine the reliability and validity of a hand cold challenge protocol using LSCI, standard thermography, and low‐cost cell phone/mobile phone thermography (henceforth referred to as mobile thermography) in patients with SSc‐related RP.MethodsPatients with RP secondary to SSc were recruited from 6 UK tertiary care centers. The patients underwent cold challenge on 2 consecutive days. Changes in cutaneous blood flow/skin temperature at each visit were imaged simultaneously using LSCI, standard thermography, and mobile thermography. Measurements included area under the curve (AUC) for reperfusion/rewarming and maximum blood flow rate/skin temperature after rewarming (MAX). Test–retest reliability was assessed using intraclass correlation coefficients (ICCs). Estimated latent correlations (estimated from multilevel models, taking values between −1 and 1; denoted as rho values) were used to assess the convergent validity of LSCI and thermography.ResultsIn total, 159 patients (77% with limited cutaneous SSc) were recruited (84% female, median age 63.3 years). LSCI and standard thermography both had substantial reliability, with ICCs for the reperfusion/rewarming AUC of 0.67 (95% confidence interval [95% CI] 0.54, 0.76) and 0.68 (95% CI 0.58, 0.80), respectively, and ICCs for the MAX of 0.64 (95% CI 0.52, 0.75) and 0.72 (95% CI 0.64, 0.81), respectively. Very high latent correlations were present for the AUCs of LSCI and thermography (ρ = 0.94; 95% CI 0.87, 1.00) and for the AUCs of standard and mobile thermography (ρ = 0.98; 95% CI 0.94, 1.00).ConclusionThis is the first multicenter study to examine the reliability and validity of cold challenge using LSCI and thermography in patients with SSc‐related RP. LSCI and thermography both demonstrated good potential as outcome measures. LSCI, standard thermography, and mobile thermography had very high convergent validity.

Intraoperative assessment of cerebral blood flow changes in normal and pathological brain tissue using an infrared camera

This study attempted to evaluate brain surface temperature using infrared thermography in patients with brain tumours, in particular those located in the vicinity of the eloquent areas. The clinical part of the study was preceded by the experiments on rats undertaken to test time-relation of cerebrocortical microflow (LDF) and brain surface temperature changes using the same infrared camera as in the clinical study. A significant positive correlation (r = 0.88, p < 0.05) between the maximum microflow changes and maximum brain temperature changes was observed. The temperature changes occurred, however, with some delay in comparison with LDF changes. In the clinical study, temperature was recorded before, during and after removal of a tumour in fifteen patients and an abscess in one patient. In patients with tumours located close to eloquent areas, temperature distribution was also measured during the awake part of the surgical procedure. The temperature of the tumour was different from the temperature of the tissues adjacent to the resected pathology. In four patients subjected to the intraoperative awake procedure, the temperature increase in the activated motor cortex region was observed. For the first time, it was possible to identify the cortical arteries supplying the eloquent areas.

Infrared Thermographic Pattern of Lower Limb Complex Regional Pain Syndrome (Type I) and its Correlation with Pain, Disease Duration and Clinical Signs

Purpose: So far, the use of infrared-thermography in the diagnosis of the Complex Regional Pain Syndrome (CRPS) has been described only for the upper extremity or jointly for the upper and lower extremity. Therefore, the aim of this study was the assessment of the absolute temperature side-to-side difference by infrared thermography in patients with CRPS Type I of the lower limb. It was investigated whether there are correlations between the amount of temperature side-to-side difference, pain, duration of the disease and clinical signs. Materials and Methods: 25 women and 11 men (mean age 48 years), who fulfilled the Budapest clinical criteria of CRPS type I, were investigated in this retrospective cross-sectional study. Infrared thermographic evaluation of the big toe, dorsal foot, ankle and distal anterior lower thigh was performed. The arithmetical mean of the absolute side-to-side differences of these 4 regions of interest was calculated=average side-to-side temperature difference of the distal lower limb. The correlation of the average side-to-side temperature difference of the distal lower limb with pain, duration of the disease and clinical signs (sensory, vasomotor, sudomotor/edema and motor/trophic) was assessed. Results: The average absolute side-to-side temperature difference of the distal lower limb was 1.6/1.2°C (mean/SD). A significant correlation between the temperature asymmetry was observed with the vasomotor signs. Conclusions: Infrared thermography offers an objective assessment of vasomotoric dysfunction in CRPS type I of the lower limb, and therefore serves as a useful supplementary tool in the diagnosis of CRPS type I.

The effectiveness of infrared thermography in patients with whiplash injury.

ObjectiveThis study aims to visualize the subjective symptoms before and after the treatment of whiplash injury using infrared (IR) thermography.MethodsIR thermography was performed for 42 patients who were diagnosed with whiplash injury. There were 19 male and 23 female patients. The mean age was 43.12 years. Thermal differences (ΔT) in the neck and shoulder and changes in the thermal differences (ΔdT) before and after treatment were analyzed. Pain after injury was evaluated using visual analogue scale (VAS) before and after treatment (ΔVAS). The correlations between ΔdT and ΔVAS results before and after the treatment were examined. We used Digital Infrared Thermal Imaging equipment of Dorex company for IR thermography.ResultsThe skin temperature of the neck and shoulder immediately after injury showed 1-2℃ hyperthermia than normal. After two weeks, the skin temperature was normal range. ΔT after immediately injuy was higher than normal value, but it was gradually near the normal value after two weeks. ΔdT before and after treatment were statistically significant (p<0.05). VAS of the neck and shoulder significantly reduced after 2 week (p=0.001). Also, there was significant correlation between ΔdT and reduced ΔVAS (the neck; r=0.412, p<0.007) (the shoulder; r=0.648, p<0.000).ConclusionThe skin temperature of sites with whiplash injury is immediately hyperthermia and gradually decreased after two weeks, finally it got close to normal temperature. These were highly correlated with reduced VAS. IR thermography can be a reliable tool to visualize the symptoms of whiplash injury and the effectiveness of treatment in clinical settings.

Screening for Osteomyelitis Using Thermography in Patients with Diabetic Foot

One of the most serious complications of diabetic foot (DF) is osteomyelitis, and early detection is important. To assess the validity of thermography to screen for osteomyelitis, we investigated thermographic findings in patients with both DF and osteomyelitis. The subjects were 18 diabetic patients with 20 occurrences of DF who visited a dermatology department at a hospital in Tokyo and underwent evaluation by magnetic resonance imaging (MRI) and thermography between June 2010 and July 2012. Osteomyelitis was identified by MRI. Thermographs were taken of the wounds and legs after bed rest of more than 15 minutes. Two wound management researchers evaluated the range of increased skin temperature. There were three types of distribution of increased skin temperature: the periwound, ankle, and knee patterns. Fisher’s exact test revealed that the ankle pattern was significantly more common in the group with osteomyelitis than in the group without osteomyelitis (P=0.011). The positive predictive value was 100%, and the negative predictive value was 71.4%. Our results suggest that an area of increased skin temperature extending to the ankle can be a sign of osteomyelitis. Thermography might therefore be useful for screening for osteomyelitis in patients with DF.

中枢性筋弛緩剤塩酸エペリゾン (ミオナール ® ) の顎関節症に対する効果

中枢性筋弛緩剤塩酸エペリゾン (ミオナール ® ) の顎関節症に対する効果

Dynamic Nasal Infrared Thermography in Patients with Nasal Septal Perforations

Nasal obstruction is a typical symptom in patients with nasal septal perforations. Rhinomanometry and acoustic rhinometry are not reliable in these cases because the perforations generate incorrect results. Infrared thermography camera (ITC) systems allow contact-free intranasal recordings of the nasal surface temperature and the semiquantification of nasal airflow. The aim of this study was to perform contact-free temperature measurements of the nasal vestibular surface by application of ITC systems in patients with septal perforations to investigate the disturbed intranasal heat exchange and nasal airflow. The surface temperature profiles within the nasal vestibules of healthy volunteers (n=10) and patients with septal perforations (n=3) were recorded with an ITC during several breathing cycles. Thermal images were taken (60/s) displaying the surface temperature in degrees centigrade corresponding to a color scale. The temperature recordings showed a disturbed intranasal heat exchange during inspiration and expiration in patients with septal perforations in comparison with healthy subjects. A reduced and irregular inspiratory cooling of the entire surface within the nasal vestibules visualizes a reduced and disturbed airflow volume. The study was able to prove the feasibility of intranasal temperature recordings of the surface with an ITC system in patients with septal perforations. Contrary to rhinomanometry and acoustic rhinometry, thermography cameras can be applied to examine airflow in patients with septal perforations. The detected reduced cooling of the surface during inspiration might be a possible explanation for the patients' feelings of nasal obstruction.

The Effect of Low-Level Laser in Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Trial

Low-level laser therapy (LLLT) is thought to have an analgesic effect as well as a biomodulatory effect on microcirculation. This study was designed to examine the pain-relieving effect of LLLT and possible microcirculatory changes measured by thermography in patients with knee osteoarthritis (KOA). Patients with mild or moderate KOA were randomized to receive either LLLT or placebo LLLT. Treatments were delivered twice a week over a period of 4 wk with a diode laser (wavelength 830 nm, continuous wave, power 50 mW) in skin contact at a dose of 6 J/point. The placebo control group was treated with an ineffective probe (power 0.5 mW) of the same appearance. Before examinations and immediately, 2 wk, and 2 mo after completing the therapy, thermography was performed (bilateral comparative thermograph by AGA infrared camera); joint flexion, circumference, and pressure sensitivity were measured; and the visual analogue scale was recorded. In the group treated with active LLLT, a significant improvement was found in pain (before treatment [BT]: 5.75; 2 mo after treatment : 1.18); circumference (BT: 40.45; AT: 39.86); pressure sensitivity (BT: 2.33; AT: 0.77); and flexion (BT: 105.83; AT: 122.94). In the placebo group, changes in joint flexion and pain were not significant. Thermographic measurements showed at least a 0.5 degrees C increase in temperature--and thus an improvement in circulation compared to the initial values. In the placebo group, these changes did not occur. Our results show that LLLT reduces pain in KOA and improves microcirculation in the irradiated area.

Thermography in Patients with Meniere's Disease

We measured the skin temperature of the cheeks of patients with Meniere's disease by thermography before and after frontal cooling by ice. Before cooling it did not differ from that of healthy controls, but cooling caused significant asymmetry in the patients.Moreover, in patients with Meniere's disease, the asymmetry of cheek skin temperature after frontal cooling was greater during activity than at rest.Skin temperature is controlled mainly by the sympathetic nervous system. Therefore, these findings suggest that asymmetry of sympathetic nerve function is a possible cause of attacks of Meniere's disease.

The value of preoperative thermography in patients undergoing reduction mammaplasty and mastopexy

The value of preoperative thermography in patients undergoing reduction mammaplasty and mastopexy

The value of preoperative thermography in patients undergoing reduction mammaplasty and mastopexy

The value of preoperative thermography in patients undergoing reduction mammaplasty and mastopexy

The Value of Preoperative Thermography in Patients Undergoing Reduction Mammaplasty and Mastopexy

The authors present telethermography as a complementary preoperative test. The procedure helps us choose the technique to be used, eliminating cases in which cutaneous glandular dissection is not advisable because of anomalous irrigation (deficient internal mammary artery). It also offers us a guide to the safe level of dissection and extirpation of the inferior internal sector of the breast, depending on the point of exit of the internal mammary vascular pedicles. Finally, it tells us which breast must be reconstructed first (the one with the least vascularization in its internal hemiglandula). Postoperative comparative telethermography may also be used to detect any pathological process that appears later.