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Influence of a meal on skin temperatures estimated from quantitative IR-thermography.

In young men at 25 degrees C, quantitative IR-thermography showed that fasting values of skin temperatures over suspected areas of brown adipose tissue (BAT) were higher than where no BAT is thought to occur. However, at 30 min and again at 60-90 min after a meal of 2.5 MJ, the magnitude of the increase in skin temperature was similar in areas with or without suspected BAT. In conclusion, either thermography was unable to detect the activation of BAT, or the meal did not stimulate heat production in the sites of suspected BAT.

Adipose Tissue, Brown↗

Thermography of frozen shoulder and rotator cuff tendinitis.

The role of thermography in the diagnosis of soft tissue lesions of the shoulder was evaluated by screening 28 patients with unilateral frozen shoulder and 86 patients with unilateral rotator cuff lesions. Index shoulders were then compared with the normal side. Differences in skin temperature distribution were found in 82% of subjects with frozen shoulder, nearly three-quarters of whom had reduced skin temperature. There was no consistent pattern of shoulder skin temperature found in rotator cuff tendinitis patients (49% normal, 28% reduced, 23% increased). Thermography can be helpful in the diagnosis of frozen shoulder but further studies are required to determine whether it is useful in other soft tissue shoulder lesions.

Adult↗

Analysis of thermal properties of wheelchair cushions with thermography.

Thermal properties of wheelchair cushions have been traditionally studied with thermistor probes, which provide temperature values of limited areas (spot analysis). In this paper, we describe a novel procedure based on thermography for assessing the distribution of temperature over the entire surface of wheelchair cushions. The thermal transient during contact with the body (heating phase) and after use (cooling phase) is considered. The procedure was tested in four different seat cushions (with a gel pad, air-filled cells, gel-filled bubbles and foam-filled bubbles) used by a normal subject. Observed results were compatible with the predicted outcomes based on an analysis of the materials and structures. Specifically: (i) air-filled cushions exhibited the fastest thermal transients, gel cushions the slowest transients, while cushions with a mixed structure exhibited intermediate behaviour; (ii) cushions made from flat surfaces of foam exhibited the highest peak temperatures (30.8 degrees C) as compared to those with air-filled cells (30.35 degrees C) or bubble-shaped surfaces (29.7 degrees C); (iii) the average temperature under the thighs was significantly higher than that under the ischiatic area in all cushions (29.6 degrees C compared with 28.7 degrees C, p < 0.05). It is shown that the present method can be used to differentiate between different cushions. Although the 'macro-analysis' inherent in thermography appears to be suited for improving cushion design, this approach should be further investigated to determine its reliability.

Adult↗

Thermography of Clostridium perfringens infection in childhood.

Gas gangrene is not a frequently encountered toxic wound infection in childhood. We present a case of postoperative Clostridium perfringens infection with proximal forearm myonecrosis. In order to reveal the full extent of tissue viability in the right upper extremity, infrared thermography was performed. Although dyschromia was evident in the proximal forearm, thermographs revealed viable tissue only up to the supracondylar region. Angiography, which provided valuable clues to the patency of the vascular supply, and subsequent intraoperative findings confirmed the extent of tissue perfusion as revealed by infrared thermography.

Amputation, Surgical↗

Infrared thermography for examination of skin temperature in the dorsal hand of office workers.

Reduced blood flow may contribute to the pathophysiology of upper extremity musculoskeletal disorders (UEMSD), such as tendinitis and carpal tunnel syndrome. The study objective was to characterize potential differences in cutaneous temperature, among three groups of office workers assessed by dynamic thermography following a 9-min typing challenge: those with UEMSD, with ( n=6) or without ( n=10) cold hands exacerbated by keyboard use, and control subjects ( n=12). Temperature images of the metacarpal region of the dorsal hand were obtained 1 min before typing, and during three 2-min sample periods [0-2 min (early), 3-5 min (middle), and 8-10 min (late)] after typing. Mean temperature increased from baseline levels immediately after typing by a similar magnitude, 0.7 (0.3) degrees C in controls and 0.6 (0.2) degrees C in UEMSD cases without cold hands, but only by 0.1 (0.3) degrees C in those with cold hands. Using paired t-tests for within group comparisons of mean dorsal temperature between successive imaging periods, three patterns of temperature change were apparent during 10 min following typing. Controls further increased mean temperature by 0.1 degrees C ( t-test, P=0.001) at 3-5 min post-typing before a late temperature decline of -0.3 degrees C ( t-test, P=0.04), while cases without cold hands showed no change from initial post-typing mean temperature rise during middle or late periods. In contrast, subjects with keyboard-induced cold hands had no change from initial post-typing temperature until a decrease at the late period of -0.3 degrees C ( t-test, P=0.06). Infrared thermography appears to distinguish between the three groups of subjects, with keyboard-induced cold hand symptoms presumably due, at least partially, to reduced blood flow.

Adult↗

Thermography - a valuable tool to test hydrocephalus shunt patency.

INTRODUCTION: Shunt-function in hydrocephalic patients is verified by clinical examination and repeated cranial computed tomography (CCT) in most cases. Because of the disadvantages of multiple radiation especially in children it was our aim to introduce video-thermography as a simple and non-invasive methodology to evaluate shunt function. METHODS: 54 patients treated with shunts for hydrocephalus were tested. A ventriculo-peritoneal shunt had been implanted in 38 patients, a ventriculo-atrial shunt in 16 patients. Recent CCT-scans were available for all patients and served as control. None of the patients presented with clinical signs of shunt-dysfunction. The temperature of the skin covering the drainage catheter distal to the valve was recorded real-time by a calibrated infrared camera. After cooling the skin area downstream of the valve for exactly 1 min with an ice pack, changes of the skin temperature in the area downstream were registered by a thermocamera. The signals were transferred to a video screen and recorded on videotape. By off-line analysis of the obtained pseudo colour images variations of 0.1 degrees C in skin temperature could be measured. RESULTS: Temperature distribution of the area under investigation revealed a significant reduction of the skin temperature according to the location of the downstream catheter segment in 48 patients after cooling. In 6 patients skin temperature remained constant, although clinical evaluation and CCT-scan showed no signs of shunt dysfunction. Shunt patency could be verified in more than 85% of the patients by thermal imaging. CONCLUSION: Infrared-thermography is a valuable and promising tool for replacing CCT-scanning as a screening method to test shunt function in hydrocephalic patients.

Adolescent↗

Infrared thermography in the detection and management of coronary artery disease.

Infrared thermography was used to measure and map precordial skin temperature in 60 patients undergoing elective coronary angiography; 9 patients were normal and 51 had coronary artery disease (CAD). Thermograms were graded by quartile area (zero to 4 plus) and magnitude of thermal asymmetry (recorded as degrees celsius). The presence, mean area and degree of thermal asymmetry were significantly greater in patients with CAD. Twenty-two patients subsequently underwent successful revascularization with angioplasty with a highly significant decrease in the presence, magnitude and degree of thermal asymmetry. The results demonstrate that CAD is associated with precordial thermal asymmetry. The area and magnitude of thermal asymmetry is greater in patients with CAD than in control subjects without angiographically significant CAD. Successful revascularization changed the asymmetric precordial pattern to a more symmetric one. Infrared thermography is a promising technique for the detection of CAD before and after revascularization.

Adult↗

Devices for the diagnosis and treatment of temporomandibular disorders. Part III: Thermography, ultrasound, electrical stimulation, and electromyographic biofeedback.

This last article in the three-part series on devices for the diagnosis and treatment of temporomandibular disorders (TMD) compared the claimed diagnostic usefulness of thermography with the present scientific evidence. In a similar manner, the therapeutic efficacy of ultrasound, electrical stimulation, and electromyographic biofeedback was also reviewed. This evaluation concluded that the application of thermography to the diagnosis of TMD is limited by variations within and among subjects and by intrinsic problems with controls of the test environment. It also concluded that evidence that therapeutic ultrasound alone is useful for the treatment of TMD is lacking, that positive clinical results of electrical stimulation may not be due to specific therapeutic effects, and that it is doubtful that the use of electrical stimulation devices can produce a position of the mandible that has any diagnostic or therapeutic significance. There is evidence, however, that relaxation training, assisted by EMG biofeedback, can reduce daytime muscle activity.

Biofeedback, Psychology↗

Liquid crystal thermography in the evaluation of chronic back pain: a comparative study.

This research involves the relative value of liquid crystal contact thermography (LCT) as compared to the physical examination, myelography, electromyography and CT scanning in the examination of 155 chronic low back pain patients. Thermograms were interpreted by two independent examiners as positive for nerve root compromise. Results demonstrate excellent interobserver reliability when used for this specific purpose and respectable correlations with the physical examination and EMG studies were obtained. Somewhat less correlation was found between LCT and the diagnostic procedures of CT scanning and myelography, especially in the postoperated patient. Liquid crystal contact thermography shows some promise as an adjunctive diagnostic tool in the assessment of chronic back pain patients with radicular symptoms, especially where further surgery is contemplated and the more structural tests of CT scanning and myelography may be falsely positive as a result of previous back surgery.

Adult↗

Thermography of menopausal hot flushes.

The skin temperature changes associated with menopausal hot flushes have been examined by thermography on a small group of patients. The subjective sensation of heat during a flush seems to be out of proportion to the actual skin temperature increase which was only about 1 degrees C on the face, neck and upper chest during this study. The increased temperature on the cheeks often persisted for several minutes after the symptoms of the flush had subsided, whereas sweating on the forehead produced a more rapid local cooling effect. Sequential temperature changes were portrayed by using an AGA Thermovision Model 680 Medical System with a colour isotherm attachment. This study provided colourful objective evidence that the symptoms of menopausal flushing is associated with an increase of skin temperature which may be monitored by thermography.

Climacteric↗

Static thermography revisited--an adjunct method for determining the depth of the burn injury.

The aim of the study was to investigate the relationship between the static thermography figure of merit DeltaT (the difference in mean values of skin area temperature for the burn wound area and the unaffected reference skin area) and a means of burn classification which would be most suitable for the choice of treatment. The work was an in vivo animal experiment. Statistical analysis showed a high correlation between the DeltaT parameter and histopathological assessment. With regard to the choice of treatment, the most useful correlation was found to be that between DeltaT and the classification of burn wounds into those healed in 3 weeks and those unhealed. The results of this study have revealed a quantitative criterion DeltaT for burn classification. The study suggests that particular burn centres using static thermography use a DeltaT parameter based on their own values for burn classification so as to group burn wounds into those that healed in 3 weeks and those that did not heal. This criterion should be independent of and replace other classification systems. A criterion for the proper choice of burn treatment would then be made more readily available.

Animals↗

Coronary sinus thermography in idiopathic dilated cardiomyopathy: correlation with systemic inflammation and left ventricular contractility.

BACKGROUND: Previous studies have demonstrated that patients with heart failure have increased myocardial heat production. Coronary sinus (CS) thermography is a new method for the evaluation of left ventricular heat production. AIMS: We investigated whether the CS blood temperature is increased in patients with idiopathic dilated cardiomyopathy (DCM) compared to a control group and whether the CS blood temperature correlates with ejection fraction and systemic inflammatory activation. METHODS AND RESULTS: We included 25 patients with DCM and 22 healthy subjects. Temperature measurements were performed using a new thermography catheter. Temperature difference (DeltaT) was defined as the difference between the CS and RA blood temperature. The CRP levels were also measured. DeltaT was significantly greater in patients with DCM compared to the controls (0.25+/-0.09 vs 0.14+/-0.07 degrees C, p<0.01). DeltaT and EF were inversely correlated in patients with DCM (R=0.43). We categorized patients with DCM into two groups using a CRP cut-off value of < or =1 mg/dL. DeltaT in patients with high CRP was less (0.21+/-0.06 degrees C) compared to patients with low CRP (0.30+/-0.08 degrees C, p=0.01). CONCLUSIONS: In patients with DCM increased heat production from the myocardium, as estimated from the coronary sinus blood temperature, was demonstrated, interestingly there was no correlation with systemic inflammatory activation.

Body Temperature↗

A comparative study for the development of a thermal odoscope for the wearable dynamic thermography monitoring.

BACKGROUND: The need of the reliable continuous monitoring of temperature is rising in many clinical applications. Today the use of thermography has become central for instance in the analysis of breast cancer, for the survey of inflammatory processes and certain skin areas during physical exercise. The core of the problem is the development of an ad hoc instrument, because traditional methodologies such as infrared and liquid crystals are no longer suitable. MATERIAL AND METHODS: We developed a dedicated simulation set-up using Matlab R12 procedures (The Mathworks, USA) and P-spice models (Interlink, USA). We simulated the realisation and use of three different equipment configurations for thermography, one based on PTC sensors, another on thermocouples, a third one on specific integrated silicon components. We also bench tested one prototype. RESULTS: The results showed the feasibility of the realisation of the instrument and the validity of the data obtained by means of the simulation.

Computer Simulation↗

A comparison of thermography, radioisotope scanning and clinical assessment of the knee joints in haemophilia.

Thermography, radioactive scanning and clinical assessment of the knee joints of a series of patients with haemophilia or Christmas disease have been performed. A positive correlation was found between the abnormalities of the thermograms, radioactive scans and the clinical signs in acute haemarthrosis, but not in chronic haemophilic joint disease nor in patients without clinical joint disease. No correlation between the thermograms, radioactive scans and the number of previous joint bleeds was shown. Thermography and radionuclide scanning provide rapid means of quantifying changes within the haemophilic joint and may be useful in assessing treatment of haemophilic haemarthrosis.

Adolescent↗

Thermography in lower limb arterial disease.

Skin temperature distributions are described which correspond to different levels of arterial obstruction in the lower limbs. These temperature distributions are conveniently observed using thermography. Thermography may be used to measure the change in skin temperature when the limb performs work. These skin temperature changes have been correlated with the impairment of blood flow to the lower limb.

Adult↗

Lack of correlations between penile thermography and pelvic arteriography in 29 cases of erectile impotence.

We studied 29 cases of penile impotence to determine whether thermography could be used to screen for cases of vascular origin and, therefore, candidates for arteriography. Sixteen thermographic parameters were used to compare 3 groups of patients having normal, mildly altered and severely stenotic arteries on arteriography of the aortic bifurcation and selective catheterization of the hypogastric arteries. The averages of these parameters were computed for each of the 3 groups, and 104 comparisons then were made using student's t test. A significant difference was found between 2 groups in only 2 of the comparisons (p less than 0.05) and no threshold for significant differences was found. Penile thermography did not correlate with pelvic arteriography and does not appear useful in the selection of candidates for arteriography.

Adult↗