Thermal Imaging as a Noninvasive Diagnostic Tool for Anterior Knee Pain Following Implantation of Artificial Knee Joints (original) (raw)
Related papers
Physiotherapy Practice and Research, 2015
BACKGROUND: A number of research papers and theoretical clinical models summarising how temperature of the skin over the knee may be altered according to different pathological processes have been published. Thermal imaging (TI) is generally regarded as the 'Gold' or 'reference' standard for measuring skin temperature, however this technology is not widely accessible to most musculoskeletal physiotherapists working in clinical environments. This is largely due to the time required for analysis of the thermal images and high cost of the equipment. A digital thermometer (DT) is portable with a convenient display of results which could offer an inexpensive substitute. AIM: This study determined interchangeability between thermal imaging and a digital thermometer, using Bland-Altman limits of agreement, to determine skin temperature differences between right and left knees. METHOD: 71 healthy participants in the age group of 8 to 40 participated in the study. Data were collected in two phases. The first phase was as part of a public engagement event at the Lancashire Science Festival where school children were invited to learn about science. The second phase of data collection took place as part of a PhD study where staff and students at the university were recruited via electronic advert and posters displayed around the campus. All subjects were free from lower back or lower limb problems and had not had any previous lower limb surgery. RESULTS: Matched paired t tests showed no significant difference between temperature difference between right and left using DT and TI (t= 1.41, df= 69, P= 0.08). The DT and TI were interchangeable to measure knee skin temperature difference with a limit of agreement of-0.64 and 0.75; this limit of agreement is acceptable based on previous literature where skin temperature differences between affected and non-affected knees are equal to or greater than 1°C. CONCLUSION: This study concludes that an inexpensive handheld digital thermometer shows acceptable agreement with a thermal imaging camera. Clinically a handheld digital thermometer has the potential to play an important role in the localized assessment of skin temperature in physiotherapy and can offer an inexpensive substitute to thermal imaging; due to the massive difference in cost it is worth considering the adoption of digital thermometry in routine musculoskeletal physiotherapy practice.
Journal of Clinical Medicine
The aim of this study was to evaluate osteoarthritis (OA) patients with infrared thermography to investigate imaging patterns as well as demographic and clinical characteristics that influence knee inflammation. Forty patients with one-sided symptomatic knee OA were included and evaluated through knee-specific PROMs and the PainDETECT Questionnaire for neuropathic pain evaluation. Thermograms were captured using a thermographic camera FLIR-T1020 and temperatures were extracted using the software ResearchIR for the overall knee and the five ROIs: medial, lateral, medial patella, lateral patella, and suprapatellar. The mean temperature of the total knee was 31.9 ± 1.6 °C. It negatively correlated with age (rho = −0.380, p = 0.016) and positively correlated with BMI (rho = 0.421, p = 0.007) and the IKDC objective score (tau = 0.294, p = 0.016). Men had higher temperatures in the knee medial, lateral, and suprapatellar areas (p = 0.017, p = 0.019, p = 0.025, respectively). Patients with...
Biomedical engineering online, 2004
The skin temperature distribution of a healthy human body exhibits a contralateral symmetry. Some nociceptive and most neuropathic pain pathologies are associated with an alteration of the thermal distribution of the human body. Since the dissipation of heat through the skin occurs for the most part in the form of infrared radiation, infrared thermography is the method of choice to study the physiology of thermoregulation and the thermal dysfunction associated with pain. Assessing thermograms is a complex and subjective task that can be greatly facilitated by computerised techniques. This paper presents techniques for automated computerised assessment of thermal images of pain, in order to facilitate the physician's decision making. First, the thermal images are pre-processed to reduce the noise introduced during the initial acquisition and to extract the irrelevant background. Then, potential regions of interest are identified using fixed dermatomal subdivisions of the body, is...
Infrared Physics & Technology, 2015
h i g h l i g h t s We reviewed the effectiveness of IR imaging in the diagnosis/monitoring of knee diseases. Good results were reported for the diagnosis of osteoarthritis, rheumatoid arthritis, ligaments and tendons problems. The best results were reported for monitoring of the patients after knee arthroplasty. IR imaging proved to be a sensitive diagnosis/monitoring method for these knee conditions.
Application of Infrared Thermography in Rabbit Orthopaedic Models
2018
The rectal or internal temperature (BT) is a reference method for body temperature. BT and ear temperature (BTear) were recorded in rabbit orthopaedic experimental model-White New Zeeland rabbits (N = 14), for a six day post-surgery period. Ear (BTear) temperature measured with infrared thermography (IRT) camera was compared with rectal body temperature (BT) measured with digital thermometer. Each BTear and BT methods were studied by analysis of variance and for BT classes such as: hypothermia (BTh≥ than 38,5 о C), normothermia (BTn) and hyperthermia or fever (BTf ≥ 40,0 о C). Mean differences, linear regression and Pearson correlation were analysed. BTear was positively correlated with rectal temperature (BT); r=+0.579 at p <0.001. The regression equation model was statistically acceptable (p<0.001) and value of internal body temperature can be estimated on ITR measurements by relation: BT (о C) = 25.498 + BTear x 0.361 with R 2 =0.336. This study demonstrates that IRT technology, a passive and non-contact technology can be effectively used for estimating BT changes in rabbits.
Archives of Physical Medicine and Rehabilitation, 2006
To develop an anatomic marker system (AMS) as an accurate, reliable method of thermal imaging data analysis, for use in cryotherapy research. Investigation of the accuracy of new thermal imaging technique. Hospital orthopedic outpatient department in England. Consecutive sample of 9 patients referred to anterior knee pain clinic. Not applicable. Thermally inert markers were placed at specific anatomic locations, defining an area over the anterior knee of patients with anterior knee pain. A baseline thermal image was taken. Patients underwent a 3-minute thermal washout of the affected knee. Thermal images were collected at a rate of 1 image per minute for a 20-minute re-warming period. A Matlab (version 7.0) program was written to digitize the marker positions and subsequently calculate the mean of the area over the anterior knee. Virtual markers were then defined as 15% distal from the proximal marker, 30% proximal from the distal markers, 15% lateral from the medial marker, and 15% medial from the lateral marker. The virtual markers formed an ellipse, which defined an area representative of the patella shape. Within the ellipse, the mean value of the full pixels determined the mean temperature of this region. Ten raters were recruited to use the program and interrater reliability was investigated. The intraclass correlation coefficient produced coefficients within acceptable bounds, ranging from .82 to .97, indicating adequate interrater reliability. The AMS provides an accurate, reliable method for thermal imaging data analysis and is a reliable tool with which to advance cryotherapy research.
An Overview of Recent Application of Medical Infrared Thermography in Sports Medicine in Austria
Sensors, 2010
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 MITś 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.
Functional infrared thermal imaging: A contemporary tool in Soft tissue Screening
Scientific Reports, 2020
Soft tissue injury screening faces two main diagnostic challenges. one is the perceptual bias of the athlete in terms of referred pain and second injury assessment tools are not only in need of highly specialized personal but they are also financially demanding. Since ankle sprains is one of the leading soft tissue injuries, the current study was set to examine the suitability of functional infrared thermal imaging (fITI) in evaluating physiological alteration on the ankle as a result of exercise or injury. The current study consists of a case report of a patient with an ankle sprain and the behavior of temperature after a series of physiotherapy sessions. Moreover to strengthen the communication of the report, results from a healthy population sample were added to draw a deeper understanding on physiological temperature manifestations on soft tissue. Twenty participants underwent a 30-minute treadmill run with pictures of their ankles being taken during rest and after exercise. In addition the case of a patient is reported that has suffered an ankle sprain followed for a period of over a month. It was observed that the temperature of the ankles of participants that underwent physical exercise rose on average by 2.4 °C after taking into account both the medial and lateral sides of the both ankles. In addition the patient's left ankle appeared to be 2.5 °C above the temperature of the non-affected right ankle. This phenomenon of unilateral hyperthermia of the left injured side seems to start to dissipate by the 21 st day following the injury, completely resolving by the 42 nd day achieving bilateral isothermia in both ankles. Thermal imaging provides a reliable tool for the screening of soft tissue strain and injury. The current study further expands the literature on soft tissue screening with the use of thermal imaging, adding a quantifiable way for assessing the extend of tissue damage. The implemented method of analyses offers a suggested simple way not only in visualizing trauma but also physical strain. Nevertheless further investigations with a variety in the severity of ankle sprains need to be applied in order for thermal imaging to be used as a first line tool for the assessment and recovery of ankle sprains. Over the years with the progress of technology thermal imaging has managed to make leaps on ergonomics capitalizing on the progress of nanotechnology and lens engineering. Functional infrared imaging in now portable and more sensitive on infrared dynamics compared to what it used to be when the technique first begun its journey with the Pyroscan in 1959 in Bath 1. As a result of sensitivity and design infrared thermal imaging has now gained a reasonable exposure over the last 20 years specifically in the potential that it holds in a clinical setting specifically for soft tissue screening 2. Acute injury presents the organism with two types of challenges; prevent a possible infection as well as repair the wound and heal the body. To facilitate the physical needs of the body a population of different cells is recruited such as platelets, endothelial cells, macrophages, lymphocytes neutrophils and fibroblasts 3. Heat, swelling, redness and pain usually accompany inflammation, due to factors such as the release of endothelial nitric oxide (NO) and prostaglandins (PGI 2 and PGE 2), platelet derived growth factor and endothelial growth factor can lead to elevated heat patterns 3. Whereas the former can lead to vasodilation, the later can enhance proliferation and angiogenesis. The change in metabolic and vascular distribution from the "norm" makes tissue thermal changes visible on the infrared spectrum 4. Asymmetries in the circulation of focal body heat above <1 °C are an indication of an abnormality. Inflammation in its majority is measured on subjective scales that rate pain, redness, gross functional measures (movement/resistance) and volumetric changes such as swelling 5. All of these subjective
Thermographic: a tool of aid in physical therapy diagnosis – literature review
Manual Therapy, Posturology & Rehabilitation Journal, 2014
Introduction: Maintaining body temperature by the human body occurs through the control of the autonomic nervous system in the cutaneous microcirculation, it is necessary for there to be effective in chemical reactions and consequent maintenance of homeostasis. The human body exhibits a thermal symmetry. When any asymmetry occurs relating the contralateral area, there are some evidences of a series of cases, ranging from an inflammatory process to neurovascular changes. Thermography makes the analysis of the temperature distribution on the surface of the skin, being a tool that can be used in assessment and diagnosis of such disorders, contributing to the evolution of the treatment of patients led to physiotherapy services. Objective: To investigate the importance of thermography as an adjunct diagnostic tool in physical therapy, showing its applicability. Method: This is a literature review using various electronic databases such as PubMed, Science Direct, Scopus, Web of Science an...