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Rahbek O, Husum HC, Fridberg M, Ghaffari A, Kold S. Intrarater Reliability of Digital Thermography in Detecting Pin Site Infection: A Proof of Concept Study. Strategies Trauma Limb Reconstr 2021; 16:1-7. [PMID: 34326895 PMCID: PMC8311748 DOI: 10.5005/jp-journals-10080-1522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aim and objective The purpose of this study was to explore the capability and Intrarater reliability of thermography in detecting pin site infection. Materials and methods This is an explorative proof of concept study. Clinical assessment of pin sites was performed by one examiner with the Modified Gordon Pin Infection Classification from grade 0 to 6. Thermography of the pin sites was performed with a FLIR C3 camera. The analysis of the thermographic images was done in the software FLIR Tools. The maximum skin temperature around the pin site and the maximum temperature for the whole thermographic picture were measured. An Intrarater agreement was established and test-retests were performed with different camera angles. Results Thirteen (four females, nine males) patients (age 9–72 years) were included. Indications for frames: Fracture (n=4), two deformity correction, one lengthening and six bone transport. Days from surgery to thermography ranged from 27 to 385 days. Overall, 231 pin sites were included. Eleven pin sites were diagnosed with early signs of infection: five grade 1, five grade 2 and one grade 3. Mean pin site temperature for each patient was calculated, varied between patients from 29.0°C to 35.4°C (mean 33.9°C). With 34°C as cut-off value for infection, sensitivity was 73%; specificity, 67%; positive predictive value, 10%; and negative predictive value, 98%. Intrarater agreement for thermography was ICC 0.85 (0.77–0.92). The temperature measured was influenced by the camera positioning in relation to the pin site with a variance of 0.2. Conclusions Measurements of pin site temperature using the hand-held FLIR C3 infrared camera was a reliable method and the temperature was related to infection grading. Clinical significance This study demonstrated that digital thermography with a hand-held camera might be used for monitoring the pin sites after operations to detect early infection. How to cite this article Rahbek O, Husum HC, Fridberg M, et al. Intrarater Reliability of Digital Thermography in Detecting Pin Site Infection: A Proof of Concept Study. Strategies Trauma Limb Reconstr 2021;16(1):1–7.
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Affiliation(s)
- Ole Rahbek
- Department of Orthopaedics, Interdisciplinary Orthopaedics, Aalborg University Hospital, Aalborg, Denmark
| | - Hans-Christen Husum
- Department of Orthopaedics, Interdisciplinary Orthopaedics, Aalborg University Hospital, Aalborg, Denmark
| | - Marie Fridberg
- Department of Orthopaedics, Interdisciplinary Orthopaedics, Aalborg University Hospital, Aalborg, Denmark
| | - Arash Ghaffari
- Department of Orthopaedics, Interdisciplinary Orthopaedics, Aalborg University Hospital, Aalborg, Denmark
| | - Søren Kold
- Department of Orthopaedics, Interdisciplinary Orthopaedics, Aalborg University Hospital, Aalborg, Denmark
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Song YG, Won YH, Park SH, Ko MH, Seo JH. Changes in Body Temperature in Incomplete Spinal Cord Injury by Digital Infrared Thermographic Imaging. Ann Rehabil Med 2015; 39:696-704. [PMID: 26605167 PMCID: PMC4654076 DOI: 10.5535/arm.2015.39.5.696] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 05/20/2015] [Indexed: 11/05/2022] Open
Abstract
Objective To investigate changes in the core temperature and body surface temperature in patients with incomplete spinal cord injuries (SCI). In incomplete SCI, the temperature change is difficult to see compared with complete spinal cord injuries. The goal of this study was to better understand thermal regulation in patients with incomplete SCI. Methods Fifty-six SCI patients were enrolled, and the control group consisted of 20 healthy persons. The spinal cord injuries were classified according to International Standards for Neurological Classification of Spinal Cord Injury. The patients were classified into two groups: upper (neurological injury level T6 or above) and lower (neurological injury level T7 or below) SCIs. Body core temperature was measured using an oral thermometer, and body surface temperature was measured using digital infrared thermographic imaging. Results Twenty-nine patients had upper spinal cord injuries, 27 patients had lower SCIs, and 20 persons served as the normal healthy persons. Comparing the skin temperatures of the three groups, the temperatures at the lower abdomen, anterior thigh and anterior tibia in the patients with upper SCIs were lower than those of the normal healthy persons and the patients with lower SCIs. No significant temperature differences were observed between the normal healthy persons and the patients with lower SCIs. Conclusion In our study, we found thermal dysregulation in patients with incomplete SCI. In particular, body surface temperature regulation was worse in upper SCIs than in lower injuries. Moreover, cord injury severity affected body surface temperature regulation in SCI patients.
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Affiliation(s)
- Yun-Gyu Song
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School and Chonbuk National University Hospital, Jeonju, Korea
| | - Yu Hui Won
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School and Chonbuk National University Hospital, Jeonju, Korea. ; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Sung-Hee Park
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School and Chonbuk National University Hospital, Jeonju, Korea. ; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School and Chonbuk National University Hospital, Jeonju, Korea. ; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Jeong-Hwan Seo
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School and Chonbuk National University Hospital, Jeonju, Korea. ; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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Waddell RE, Marino DJ, Loughin CA, Tumulty JW, Dewey CW, Sackman J. Medical infrared thermal imaging of cats with hyperthyroidism. Am J Vet Res 2015; 76:53-9. [PMID: 25535661 DOI: 10.2460/ajvr.76.1.53] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the usefulness of medical infrared thermal imaging (MITI) as a screening tool for hyperthyroidism in cats, evaluate the need for hair clipping over the ventral aspect of the neck to achieve optimal images, and determine whether there is a change in thermal patterns at 1 and 3 months after radioactive sodium iodide I 131 treatment. ANIMALS 17 cats with and 12 control cats without hyperthyroidism. PROCEDURES All cats underwent MITI first with the hair present and then after the hair was clipped. Each cat with hyperthyroidism was subsequently appropriately treated SC with radioiodide; reevaluations, including MITI before and after hair clipping and measurement of serum thyroxine concentration, were performed 1 and 3 months after treatment. RESULTS The MITI had 80.5% and 87.5% accuracy in differentiating hyperthyroid cats from clinically normal cats before and after the hair over the ventral aspect of the neck was clipped. Among cats with an initial serum thyroxine concentration > 4.0 μg/dL, the success rate for MITI-detected response to radioiodide treatment at the 1-month reevaluation was 92.86% in unshaved cats and 85.71% in shaved cats. The success rate for MITI-detected response to radioiodide treatment at the 3-month reevaluation was 100% in unshaved and shaved cats. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that MITI was successful in differentiating between hyperthyroid cats and clinically normal cats and identifying patients with thyroxine concentration within reference interval after radioactive sodium iodide I 131 treatment.
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Affiliation(s)
- Robert E Waddell
- Department of Surgery, Long Island Veterinary Specialists, 163 S Service Rd, Plainview, NY 11803
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Actinobacillus pleuropneumoniae challenge in swine: diagnostic of lung alterations by infrared thermography. BMC Vet Res 2014; 10:199. [PMID: 25260642 PMCID: PMC4180138 DOI: 10.1186/s12917-014-0199-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 08/15/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Actinobacillus pleuropneumoniae (A.pp.) is the causative agent of porcine pleuropneumonia leading to high economic losses in the pig industry. Infrared thermography (IRT) of the thorax might offer a new method to select swine with lung alterations for further diagnostics. In this study 50 german landrace pigs were infected with A.pp. in an established model for respiratory tract disease, while 10 healthy pigs served as control animals. To avoid drift errors during IR measurements absolute skin temperatures and temperature differences between a thoracal and an abdominal region were assessed for its diagnostic validity. RESULTS IRT findings during the course of experimental A.pp.-infection were verified by computed tomography (CT) before and on days 4 and 21 after infection. Significant correlations were found between clinical scores, CT score and lung lesion score. Ambient temperature, body temperature and abdominal surface temperature were factors influencing the skin surface temperature of the thorax. On day 4 but not on day 21 after infection the right thoracal temperature was significantly higher and the difference between a thoracal region in the height of the left 10th vertebra and an abdominal region was significantly lower in infected pigs than in control pigs. At a cut off of 28°C of right thoracal temperature the specificity of the method was 100% (CI 95%: 69-100%) and the sensitivity 66% (CI 95%: 51-79%). At a cut off of 2°C temperature difference between thoracal and abdominal region on the left body site the specificity of the method was 100% (CI 95%: 69-100%) and the sensitivity 32% (CI 95%: 19-47%) with all control pigs detected negative. Orientation for lung biopsy by IRT resulted in 100% specificity and sensitivity (CI 95%: 69-100%) of bacteriological examination of tissue samples during the acute stage of infection. CONCLUSION IRT might be a valuable tool for the detection of inflammatory lung alterations in pigs, especially during the acute stage of infection and if ambient temperatures are constant during individual measurements. External and internal factors interfere with this method, so that its application in the field might be restricted to a selection of pigs for further diagnostic with adequate specificity.
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Grossbard BP, Loughin CA, Marino DJ, Marino LJ, Sackman J, Umbaugh SE, Solt PS, Afruz J, Leando P, Lesser ML, Akerman M. Medical Infrared Imaging (Thermography) of Type I Thoracolumbar Disk Disease in Chondrodystrophic Dogs. Vet Surg 2014; 43:869-76. [DOI: 10.1111/j.1532-950x.2014.12239.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2011] [Accepted: 08/01/2011] [Indexed: 11/30/2022]
Affiliation(s)
- Brian P. Grossbard
- Department of Surgery; Long Island Veterinary Specialists; Plainview New York
| | - Catherine A. Loughin
- Department of Surgery; Long Island Veterinary Specialists; Plainview New York
- The Canine Chiari Institute at Long Island Veterinary Specialists; Plainview New York
| | - Dominic J. Marino
- Department of Surgery; Long Island Veterinary Specialists; Plainview New York
- The Canine Chiari Institute at Long Island Veterinary Specialists; Plainview New York
| | - Leonard J. Marino
- Department of Surgery; Long Island Veterinary Specialists; Plainview New York
- The Canine Chiari Institute at Long Island Veterinary Specialists; Plainview New York
| | - Joseph Sackman
- The Canine Chiari Institute at Long Island Veterinary Specialists; Plainview New York
| | - Scott E. Umbaugh
- The Canine Chiari Institute at Long Island Veterinary Specialists; Plainview New York
- Computer Vision and Image Processing Laboratory; Electrical and Computer Engineering Department; Southern Illinois University at Edwardsville; Edwardsville Illinois
| | - Patrick S. Solt
- The Canine Chiari Institute at Long Island Veterinary Specialists; Plainview New York
- Computer Vision and Image Processing Laboratory; Electrical and Computer Engineering Department; Southern Illinois University at Edwardsville; Edwardsville Illinois
| | - Jakia Afruz
- Computer Vision and Image Processing Laboratory; Electrical and Computer Engineering Department; Southern Illinois University at Edwardsville; Edwardsville Illinois
| | - Peter Leando
- The Canine Chiari Institute at Long Island Veterinary Specialists; Plainview New York
- Meditherm, Inc.; Fort Myers Florida
| | - Martin L. Lesser
- The Canine Chiari Institute at Long Island Veterinary Specialists; Plainview New York
- North Shore-LIJ Health System Feinstein Institute for Medical Research, Biostatistics Unit; Manhasset New York
| | - Meredith Akerman
- North Shore-LIJ Health System Feinstein Institute for Medical Research, Biostatistics Unit; Manhasset New York
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Balbinot LF, Robinson CC, Achaval M, Zaro MA, Brioschi ML. Repeatability of infrared plantar thermography in diabetes patients: a pilot study. J Diabetes Sci Technol 2013; 7:1130-7. [PMID: 24124938 PMCID: PMC3876355 DOI: 10.1177/193229681300700505] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Infrared (IR) thermography has been used as a complementary diagnostic method in several pathologies, including distal diabetic neuropathy, by tests that induce thermoregulatory responses, but nothing is known about the repeatability of these tests. This study aimed to assess the repeatability of the rewarming index in subjects with type 2 diabetes mellitus (T2DM) and nondiabetic control subjects. METHODS Using an IR camera, plantar IR images were collected at baseline (pre-) and 10 min after (post-) cold stress testing on two different days with 7 days interval. Plantar absolute average temperatures pre- and post-cold stress testing, the difference between them (ΔT), and the rewarming index were obtained and compared between days. Repeatability of the rewarming index after the cold stress test was assessed by Bland-Altman plot limits of agreement. RESULTS Ten T2DM subjects and ten nondiabetic subjects had both feet analyzed. Mean age did not differ between groups (p = .080). Absolute average temperatures of plantar region pre- (p = .033) and post-cold stress test (p = .019) differed between days in nondiabetic subjects, whereas they did not differ in T2DM subjects (pretest, p = .329; post-test, p = .540). ΔT and rewarming index did not differ between days for both groups, and the rewarming index presented a 100% agreement of day-to-day measurements from T2DM subjects and 95% with nondiabetic subjects. CONCLUSIONS The rewarming index after cold stress testing presented good repeatability between two days a week in both groups. Despite T2DM subjects presenting no differences on absolute temperature values between days, ΔT or rewarming index after cold stress testing remain recommended beside absolute temperature values for clinical use.
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Affiliation(s)
- Luciane Fachin Balbinot
- Universidade Federal do Rio Grande do Sul, Travesa Aurora, 100 Chacara Das Pedras-Porto Alegre-RS Brazil CEP 91330300.
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Ra JY, An S, Lee GH, Kim TU, Lee SJ, Hyun JK. Skin temperature changes in patients with unilateral lumbosacral radiculopathy. Ann Rehabil Med 2013; 37:355-63. [PMID: 23869333 PMCID: PMC3713292 DOI: 10.5535/arm.2013.37.3.355] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 11/15/2012] [Indexed: 11/16/2022] Open
Abstract
Objective To clarify the relationship of skin temperature changes to clinical, radiologic, and electrophysiological findings in unilateral lumbosacral radiculopathy and to delineate the possible temperature-change mechanisms involved. Methods One hundred and one patients who had clinical symptoms and for whom there were physical findings suggestive or indicative of unilateral lumbosacral radiculopathy, along with 27 normal controls, were selected for the study, and the thermal-pattern results of digital infrared thermographic imaging (DITI) performed on the back and lower extremities were analyzed. Local temperatures were assessed by comparing the mean temperature differences (ΔT) in 30 regions of interest (ROIs), and abnormal thermal patterns were divided into seven regions. To aid the diagnosis of radiculopathy, magnetic resonance imaging (MRI) and electrophysiological tests were also carried out. Results The incidence of disc herniation on MRI was 86%; 43% of patients showed electrophysiological abnormalities. On DITI, 97% of the patients showed abnormal ΔT in at least one of the 30 ROIs, and 79% showed hypothermia on the involved side. Seventy-eight percent of the patients also showed abnormal thermal patterns in at least one of the seven regions. Patients who had motor weakness or lateral-type disc herniation showed some correlations with abnormal DITI findings. However, neither pain severity nor other physical or electrophysiological findings were related to the DITI findings. Conclusion Skin temperature change following lumbosacral radiculopathy was related to some clinical and MRI findings, suggesting muscle atrophy. DITI, despite its limitations, might be useful as a complementary tool in the diagnosis of unilateral lumbosacral radiculopathy.
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Affiliation(s)
- Jong Yun Ra
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
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Electrical Skin Resistance and Thermal Findings in Patients With Lumbar Disc Herniation. J Clin Neurophysiol 2010; 27:303-7. [DOI: 10.1097/wnp.0b013e3181eaad66] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Infernuso T, Loughin CA, Marino DJ, Umbaugh SE, Solt PS. Thermal imaging of normal and cranial cruciate ligament-deficient stifles in dogs. Vet Surg 2010; 39:410-7. [PMID: 20459492 DOI: 10.1111/j.1532-950x.2010.00677.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the capability of thermography for differentiation between normal stifles and those with cranial cruciate ligament (CCL) rupture in dogs, initially with a full hair coat and 1 hour after clipping the hair coat. STUDY DESIGN Prospective study. ANIMALS Labrador Retrievers (n=6) with normal stifle joints (controls) and adult dogs (n=10) with CCL rupture. METHODS Thermography was performed before, and 60 minutes after, clipping the hair coat from the pelvic limb. Stifle images were classified as normal or abnormal, then subclassified as clipped and unclipped hair coat. CCL deficiency was confirmed at surgery and thermographic images subsequently classified as abnormal before analysis with image processing software. RESULTS Using image recognition analysis, differentiation between normal and CCL-deficient stifles in both clipped and unclipped dogs was 85% successful on cranial images, medial, caudal, and lateral images were between 75% and 85% successful. Although there were significant increases in skin temperature after clipping in both groups (P<.0002-.0001), there were no significant temperature differences between normal and CCL-deficient stifles when the entire stifle was examined. CONCLUSION Thermography was successful in differentiating naturally occurring CCL-deficient stifles in dogs, with a success rate of 75-85%. Clipping is not necessary for successful thermographic evaluation of the canine stifle. CLINICAL RELEVANCE Thermography may be a useful imaging modality for diagnosis of CCL deficiency in dogs when CCL rupture is suspected but stifle laxity is not evident.
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Affiliation(s)
- Tomas Infernuso
- Department of Surgery, Long Island Veterinary Specialists, Plainview, NY 11803, USA
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The application of infrared thermography in the assessment of patients with coccygodynia before and after manual therapy combined with diathermy. J Manipulative Physiol Ther 2009; 32:287-93. [PMID: 19447265 DOI: 10.1016/j.jmpt.2009.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Revised: 01/15/2009] [Accepted: 01/26/2009] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study examines the potential usefulness of a novel thermal imaging technique in the assessment of local physiologic responses before and after conservative therapies for coccygodynia. METHODS Patients with coccygodynia were selected on the basis of detailed history taking, clinical examination, and dynamic series radiography. They underwent therapeutic modalities consisting of 6 to 8 sessions of manual medicine treatments (massage of the levators followed by Maigne's manipulative technique) and external physiotherapy (short-wave diathermy) 3 times a week for 8 weeks. We performed the assessments with numeric pain rating scale (NPRS) and infrared thermography (IRT) before treatment and at 12 weeks. RESULTS A total of 53 patients (6 males and 47 females) ranging from 18 to 71 years of age and clinically diagnosed with coccygodynia received the full course of therapy and assessments. There were significant differences in both NPRS and surface temperature obtained by IRT in the 12-week follow-up (P < .05). The correlation between NPRS improvement and temperature decrement was significantly high (r = 0.67, P < .01). CONCLUSIONS The study shows that IRT can objectively show the decrement of surface temperatures correlating with changes in subjective pain intensity after treatment of coccygodynia. With the advantages of being painless, noninvasive, and easy to repeat, IRT appears to be useful as a quantifiable tool for monitoring the dynamics of the disease activity in coccygodynia.
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Zaproudina N, Varmavuo V, Airaksinen O, Närhi M. Reproducibility of infrared thermography measurements in healthy individuals. Physiol Meas 2008; 29:515-24. [PMID: 18401069 DOI: 10.1088/0967-3334/29/4/007] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Loughin CA, Marino DJ. Evaluation of thermographic imaging of the limbs of healthy dogs. Am J Vet Res 2008; 68:1064-9. [PMID: 17916011 DOI: 10.2460/ajvr.68.10.1064] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe a thermographic imaging protocol, identify normal thermographic patterns (ie, color map reflecting the skin temperature distribution) for various regions of interest (ROIs) of dog limbs, and evaluate effects of clipping the coat on thermographic patterns and limb temperature in healthy dogs. ANIMALS 10 healthy dogs. PROCEDURES Each dog was thermographically evaluated in the same room (ambient temperature, 21 degrees C) via ROIs that included cranial and caudal views of the body, full lateral body views, full views of the limbs, and views of various limb regions. After initial imaging, the coat was clipped on the forelimbs and hind limbs only. Each dog was then evaluated 15 and 60 minutes and 24 hours after clipping by use of the same protocol. RESULTS For each ROI within a category (intact coat and each time point after clipping), mean temperatures were similar among the 10 dogs. Pairwise comparisons for 15 and 60 minutes and 24 hours established patterns of temperature stabilization among the 3 time points. Temperatures did not differ significantly between the left and right limbs. There was a mean success rate of 75% for use of image pattern analysis for recognition of similar thermographic patterns in the forelimbs and hind limbs. CONCLUSIONS AND CLINICAL RELEVANCE Thermography can be a viable, noninvasive imaging modality that provides consistent images with reproducible thermal patterns in ROIs examined in healthy dogs. Although the coat had a predictable influence to decrease the mean temperature, thermal patterns remained fairly consistent after the coat was clipped.
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Affiliation(s)
- Catherine A Loughin
- Department of Surgery, Long Island Veterinary Specialists, 163 S Service Rd, Plainview, NY 11803, USA
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Zaproudina N, Ming Z, Hänninen OOP. Plantar Infrared Thermography Measurements and Low Back Pain Intensity. J Manipulative Physiol Ther 2006; 29:219-23. [PMID: 16584947 DOI: 10.1016/j.jmpt.2006.01.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Revised: 08/24/2005] [Accepted: 08/24/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To study the skin temperature disorders in low back pain (LBP) patients compared with reference persons without LBP and to evaluate the relationship between pain intensity and other clinical signs and temperature abnormalities. METHODS Sixty-five patients with unilateral chronic LBP with or without referred nonradicular leg pain (29 men and 36 women; age range, 30-51 years) and 20 reference persons without LBP (7 men and 13 women; age range, 30-49 years) participated in this study. The pain level was recorded by the use of a visual analog scale (0-100). Questionnaires and a series of spinal mobility tests (the modified Schober, straight leg-raising test, finger-floor distance, side bending) were used. Thermographic images of the low back area and legs (anterior, lateral, and posterior surfaces and the plantar surfaces of feet) were taken with an infrared video camera. RESULTS The temperature changes in the plantar surface correlated with LBP intensity. The pain levels differed in the groups with the different types of temperature changes. There were significant lower extremity regional skin temperature alterations (at least 1 regional interside difference more than 0.3 degrees C) in most cases both in LBP patients and in reference persons, but plantar interside temperature difference was significantly higher in LBP patients. CONCLUSION Temperature changes of the plantar surface seem to be connected with LBP intensity. Temperature measurements may be useful as an adjunctive physiological test in the evaluation and documentation of autonomic dysfunction in LBP patients.
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Affiliation(s)
- Nina Zaproudina
- Department of Physiology, University of Kuopio, Kuopio, Finland.
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Affiliation(s)
- Kyung Joon Lim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chosun University, Gwangju, Korea
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Wells MD, Meyer AP, Emley M, Kong X, Sanchez R, Gozani SN. Detection of lumbosacral nerve root compression with a novel composite nerve conduction measurement. Spine (Phila Pa 1976) 2002; 27:2811-9. [PMID: 12486352 DOI: 10.1097/00007632-200212150-00016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Multivariate logistic regression techniques were used to develop a composite nerve conduction measurement that detects lumbosacral (L5, S1, or both) nerve root compression. OBJECTIVES To evaluate the diagnostic efficacy of a composite nerve conduction measurement for detection of lumbosacral nerve root compression. SUMMARY OF BACKGROUND DATA Nerve root involvement is characterized by clinical abnormalities and confirmed by radiologic and electrodiagnostic studies. Imaging studies visualize structural abnormalities; however, they are associated with high false-positive rates. Electrodiagnostic methods assess the physiologic integrity of the nerve roots. One form of electrodiagnostic testing, nerve conduction studies, is widely used for evaluation of musculoskeletal and neuromuscular complaints. Although similar clinical value is expected for the evaluation of nerve root compromise, prior applications of nerve conduction studies have yielded widely varying results. METHODS Two groups of subjects were compared. The L5-S1 compression group was composed of 25 patients with magnetic resonance imaging-confirmed lumbosacral (L5, S1, or both) nerve root compression and symptoms in the appropriate segmental distribution. The majority of subjects (22) had at least one of the following findings on physical examination: positive straight-leg raise test, diminished ankle reflexes, sensory loss, or weakness. The control group consisted of 35 asymptomatic individuals with no history of radiculopathy or potentially confounding neuropathology. The posterior tibial and deep peroneal nerves were evaluated bilaterally in all study subjects using standard nerve conduction procedures, which consisted of the measurement of distal motor latencies and F-wave latencies that assess nerve root pathophysiology. A composite nerve conduction measurement was determined using multivariate logistic regression analysis. The efficacy of the composite measurement was assessed by receiver operating characteristic curve analysis and by the diagnostic sensitivity and specificity. RESULTS Five F-wave latency parameters (peroneal mean F-wave latency, odds ratio = 0.42; peroneal seventh F-wave latency decile, odds ratio = 2.71; tibial mean F-wave latency, odds ratio = 8.90; tibial first F-wave latency decile, odds ratio = 0.47; tibial maximum F-wave latency, odds ratio = 0.44) were found to be predictive of nerve root compression. A composite nerve conduction measurement, NC composite, constructed from these five parameters (NC composite = exp(phi)/(1 + exp(phi)), phi = -31.2 + 1.0 * Per7 Decile - 0.88 * PerMean + 2.2 * TibMean - 0.88 * Tib1 Decile - 0.83 * TibMax) yielded an area under the receiver operating characteristic curve of 0.91. At a threshold of 0.20, NC composite had a diagnostic specificity of 84.3% and a sensitivity of 83.3%. CONCLUSION This preliminary study suggests that a novel composite nerve conduction measurement, based on F-wave latency parameters, may be highly effective at detecting magnetic resonance imaging-confirmed lumbosacral nerve root compression. Because these measurements provide objective evidence of functional nerve root compromise and are noninvasive, they may be of diagnostic value to clinicians evaluating patients presenting with low back and leg pain.
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Takahashi Y, Hirayama J, Nakajima Y. Segmental regulation pattern of body surface temperature in the rat hindlimb. Brain Res 2002; 947:100-9. [PMID: 12144858 DOI: 10.1016/s0006-8993(02)02915-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Body surface zones or 'thermatomes', whose temperature is regulated by a single spinal segment, were investigated by thermography in the rat hindlimb. First, the spatial relation between the dermatome delineated by dye extravasation and the corresponding thermatome was investigated in rats pretreated with intravenous application of Evans blue. Electrical stimulation of the spinal nerves and sympathetic trunk segments at L3 and L5 induced a distal dominant temperature decrease. In contrast, Evans blue extravasation appeared in the medial (in L3) and lateral (in L5) paw only by electrical stimulation of the spinal nerves. Second, thermatomes L1-L5 were determined in other rats. Electrical stimulation of the sympathetic trunk segments L1-L6 produced a temperature decrease in the abdomen, hindlimb, and tail. However, the hindlimb temperature was regulated mainly by L2-L5 levels, particularly by L4 and L5. The abdomen was regulated uniformly by L1-L6, and the tail by L6. It was demonstrated that thermatomes are manifested differently from the corresponding dermatomes in the rat hindlimb.
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Affiliation(s)
- Yuzuru Takahashi
- Departments of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
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Abstract
Infrared thermographic imaging (ITI) is the most sensitive objective imaging currently available for the detection of back disease in horses. It is, however, only a physiological study primarily of vasomotor tone overlying other superficial tissue factors. Interpretation requires extreme care in imaging protocol and in understanding the significance of altered sympathetic nervous tone and the sympathetic distribution. Most discussions on back pain have centered on nociception and inflammatory events. ITI provides information and localization for more significant than diagnosing areas of hot spots. Chronic back pain usually involves vasoconstriction at the affected sites and from ITI studies in man, we have an opportunity to appreciate chronic pain phenomena that involves non-inflammatory events. These occur commonly in horses, but are still seldom recognized and treated.
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Knowledge-based expert systems. Clin Neurophysiol 1995. [DOI: 10.1016/b978-0-7506-1183-1.50021-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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20
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van Dijk JG. Vector short-latency somatosensory-evoked potentials. Muscle Nerve 1991; 14:781-4. [PMID: 1891002 DOI: 10.1002/mus.880140814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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21
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Thomas D. Thermography. Med J Aust 1991. [DOI: 10.5694/j.1326-5377.1991.tb121331.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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22
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Abstract
OBJECTIVE To evaluate the currently perceived status of thermography in the diagnosis of musculoskeletal disorders. DATA SOURCES Medical and legal journals published from 1956 onwards; report of the United States Office of Health Technology Assessment and personal communication with the author of that report. STUDY SELECTION Confined to application of thermography to musculoskeletal and neurological medicine. DATA EXTRACTION AND SYNTHESIS Weighted towards prospective and controlled studies. CONCLUSION Little evidence exists of any application of thermography in which it is unequivocally superior to conventional diagnostic imaging methods.
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Affiliation(s)
- M S Awerbuch
- Pain Management Unit, Memorial Medical Centre, North Adelaide, SA
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So YT, Olney RK, Aminoff MJ. A comparison of thermography and electromyography in the diagnosis of cervical radiculopathy. Muscle Nerve 1990; 13:1032-6. [PMID: 2172814 DOI: 10.1002/mus.880131106] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We studied 20 asymptomatic control subjects and 14 patients with clinically unequivocal cervical radiculopathy to compare the diagnostic value of thermography with that of electromyography. We measured the average skin temperature of designated regions over the neck, shoulder, and upper extremities. We then compared the temperature between corresponding regions of the two limbs, and between fingers innervated by different roots in the same hand. Thermography was abnormal in 6 patients (43%), whereas electromyography was abnormal in 10 (71%). Thermographic abnormalities were seen only in the hands and fingers, and the pattern did not follow the dermatome of the clinically involved cervical root. When compared to electromyography, thermography provided no additional diagnostic information. Thus, thermography does not have an established role in the evaluation of patients with cervical radiculopathy.
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Affiliation(s)
- Y T So
- Department of Neurology, School of Medicine, University of California, San Francisco 94143
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