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a thermographic images showing the areas of temperature measurement at metacarpophalangeal (MCP) and distal interphalangeal (DIP) joints on the dorsal aspect of hands. b the measurement of the distal-dorsal difference (DDD) on the III finger of a girl with secondary Raynaud's phenomenon
Source publication
Background:
Infrared Thermography (IRT) has been used for over 30 years in the assessment of Raynaud Phenomenon (RP) and other peripheral microvascular dysfunctions in adults but, to date, very little experience is available on its use in children for this purpose. The first aim of the study was to assess reproducibility of thermographic examinati...
Contexts in source publication
Context 1
... by two physicians with low or null experience in IRT (MC and RC) and no specific training was performed. For each image acquired before and during the test (pre-test, T 0 to T 10 ) the following data were measured: mean temperature at dorsum of MCP and distal interphalangeal joints (DIP) of the II, III, IV and V finger of both hands as showed in Fig. ...
Citations
... Nail fold capillaroscopy revealed disorganization of the microvasculature, megacapillaries, branching capillaries, microbleeding, and avascular areas compatible with an "active scleroderma pattern" (Fig. 2). Cold challenged infrared thermography showed at 10 minutes, an abnormal temperature gradient (deltaT) > 1 °C in all fingers form metacarpophalangeal to distal interphalangeal joints [7]. Pulmonary function tests revealed a restrictive pattern with mild reduction of the diffusing capacity of the lungs for carbon monoxide (DLCO) (DLCO 72%, TLCO 73%, KCO 74%). ...
... Some capillaroscopy changes can also be observed in advanced diabetes, but they are characterized by a completely different pattern from SSc with reduced blood flow in capillaries and isolated homogeneous engorgement of venular limbs [18]. Infrared thermography with cold challenge can also help in the differential diagnosis [7]. The test can be abnormal in both SSc and diabetes, but due to completely different pathophysiology. ...
Background
Limited joint mobility (LJM), previously known as cheiroarthropathy, refers to the presence of reduced extension at the finger joints in people with diabetes and may be associated with scleroderma-like syndromes such as diabetic sclerodactyly.
While scleroderma-like syndromes and LJM have been observed in patients with long-term diabetes and associated complications, the coexistence of diabetes with Juvenile systemic sclerosis (jSSc) is rarely described.
Case presentation
We describe the case of a 14-year-old boy with long-lasting type 1 diabetes (T1D) and suspected LJM associated with Raynaud phenomenon, sclerodactyly and tapering of the fingertips. A comprehensive work-up showed positive autoantibodies (ANA, anti-Ro-52, anti-Mi-2b), abnormal nailfold capillaroscopy with a scleroderma pattern, interstitial lung disease and cardiac involvement. The overall clinical picture was consistent with the diagnosis of jSSc.
Conclusions
LJM can be the initial sign of underlying systemic sclerosis. Nailfold capillaroscopy may help differentiate jSSc from classical LJM in pediatric patients with T1D and finger contractures or skin induration of no clear origin.
This case report provides a starting point for a novel hypothesis regarding the pathogenesis of jSSc. The association between T1D and jSSc may be more than a coincidence and could suggest a relationship between glucose metabolism, fibrosis and microangiopathy.
... There are various other lesser-used tests that healthcare professionals can still utilize in order to diagnose Raynaud's. Many of these highly effective tests, some newer and some older, include Computed Tomography (CT)-guided percutaneous thoracic sympathetic chain radiofrequency thermocoagulation, testing for Th1-and Th17-related cytokines in venous and arterial blood, infrared thermography, photoacoustic and highfrequency ultrasound imaging, and more [12,[29][30][31]. ...
Case presentation The patient is a 24-year-old male, living in south Phoenix, Arizona, USA. He has been suffering with Raynaud's for roughly 8 years at the time this case study was written. The patient initially presented with his chief complaint of hand color changes and painful stimuli when exposed to the cold. He states that two to three of the digits of the hands bilaterally will become pale to white with any minor stimuli of cold exposure and that this leads to increased pain sensation when his hands rewarm. He states the symptoms developed roughly around sophomore year of high school and that they were initially only right sided, but have now become bilateral. He endorses that stress and negative emotional mindsets may cause the phenomena to occur at higher temperatures or become worse, sometimes with him experiencing symptoms up to the mid 70-degree Fahrenheit (~24-degree Celsius) range. The patient stated that his mother suffered with similar symptoms, but could not remember the name of the disorder, only stating that, "her hands would start to get 'frostbitten' very easily, and the first symptom was her hands turning white". The patient stated that when his mother sought medical attention for her condition, the physician did not know anything about the condition, telling her to "dress intelligently for cold tem-peratures". Remembering this experience, the patient had not previously sought out medical attention for himself for the assumption that he would simply be told the same thing. The patient noted that in addition to the spread and decreasing temperatures of the symptoms in his hands, the onset Abstract This case presentation assesses one example of a patient suffering from Raynaud's phenomenon without having previously sought out medical intervention. This study focuses on the patient's perspective in hopes of providing insight to future providers in handling patient interactions for those suffering with the same disease. As little about the disease is widely known, this study will address the etiology, patho-physiology, diagnostic tests, current and experimental treatment options , and known genetic components of Raynaud's disease. The goal of the authorial team is to bring attention to the patient's perspective to increase rapport, treatment compliance, and increase provider understanding of the language they use to bring up symptomology. This case also looks to help primary care physicians better characterize the patient's disease state. It is the hope of this research team that available treatments and therapies will become more widely known and understood for the purpose of healthcare professionals to incorporate them into their potential appointments with patients suffering from these conditions.
... 9 Thermography has been used to diagnose and evaluate several diseases that cause changes in local body temperature, including Raynaud's The Value of Thermal Imaging for Knee Arthritis: A Single-Center Observational Study phenomenon, scleroderma, burns, and diabetic feet. 10,11 Inflammation, infection, or malignancy can cause a local temperature rise that can be detected by thermal imaging. Thermography has also emerged as another non-invasive imaging tool for evaluating arthritis in that it reflects increased pathological blood flow associated with inflamed joints. ...
Purpose:
To compare (non-contact) thermal imaging with power Doppler (PD) for the evaluation of knee arthritis with joint effusion.
Materials and methods:
We enrolled patients with knee arthritis who were scheduled to undergo an arthrocentesis of the knee from April to December 2020 at a single tertiary hospital. A thermography camera, FLIR ONE Pro, was used to obtain both thermographic and digital images on subjects. For each subject, thermography, ultrasonography, arthrocentesis, and blood tests were conducted at the same study visit. Thermal imaging findings and clinical characteristics were compared by dividing the subjects into PD-positive and PD-negative groups on ultrasound. The receiver operating characteristic (ROC) curve analysis was used to determine the accuracy of PD positivity.
Results:
A total of 30 knee arthritis patients were enrolled in this study. Knee temperature was significantly higher in PD-positive group compared to PD-negative group [maximum temperature (T max): 33.2℃ vs. 30.5℃, p=0.025; minimum temperature (T min): 30.7℃ vs. 27.0℃, p=0.015; average temperature (T ave): 32.1℃ vs. 29.1℃, p=0.016]. Also, the joint fluid white blood cell count was considerably higher in PD-positive group than in PD-negative group (24556 cells/mm3 vs. 7840 cells/mm3, p=0.010). The area under the ROC curve of the point measurement of T max, T min, and T ave ranged between 0.764 and 0.790.
Conclusion:
In this study, we found that high thermographic temperatures of the knee suggest a positive PD signal. Thus, thermography might be used as an adjuvant tool of PD for non-invasive evaluation of knee arthritis.
... Capillaroscopy was abnormal with many dilated capillary loops but no clear scleroderma pattern. A cold-challenged thermography showed a prolonged rewarming time at second, third and fifth fingers of both hands, a pattern suggestive for RP ( Fig. 1A and B) [11]. MRI of the right hand showed intense bone oedema involving the third metacarpus and the proximal third phalanx, and joint effusion with synovial thickening of the third MCP joint ( Fig. 1C and D). ...
Objective
Juvenile Systemic Sclerosis (JSSc) is a rare condition in childhood and its variety with no skin involvement, sine scleroderma (ssJSSc), is anecdotal. We report the first case series of patients with ssJSSc.
Methods
Demographic, clinical and laboratory data of patients with JSSc followed at our Centre were retrospectively collected. Patients with no skin involvement but with all of the following features: Raynaud’s phenomenon, positive ANA, intestinal dysmotility and/or interstitial lung disease (ILD) or pulmonary arterial hypertension (PAH) and/or cardiac or renal involvement typical of scleroderma were defined as having ssJSSc and compared with those with classic JSSc (cJSSc).
Results
Among 52 JSSc patients seen in 20 years, 5 (9.6%) presented with ssJSSc. Their clinical features and those of the only two patients reported in the literature so far, were compared with classical JSSc with available complete data. Six patients had cardiac involvement as presenting feature, three primary cardiomyopathy, three secondary to PAH. Two patients died after a brief disease course and one rapidly underwent heart transplantation. In comparison with cJSSc, ssJSSc showed a significantly longer diagnostic delay (20.1 vs 8.3 months, p 0.017), higher frequency of cardiac involvement (85.7 vs 15.6%, p 0.001) and worse outcome, intended as mortality or end-stage organ failure rates (42.9% vs 6.2%, p< 0.001).
Conclusion
Cardiac involvement represents the most important characteristic of ssJSSc and carries a high morbidity and mortality rate. The longer delay in diagnosis underlines the need for a comprehensive rheumatologic work-up in patients with isolated cardiomyopathy or PAH/ILD.
... Тепловидение оказалось надежным и воспроизводимым методом объективной количественной оценки тяжести заболевания и прогноза его развития с течением времени и в ответ на лечение у детей с патологическим Рисунок 4. Больной Ш., 24 года, диагноз ФР подтвержден капилляроскопией: исходно, 30 с после ХП, 1 мин., 3 мин., 5 мин., 10 мин. периферическим кровообращением, особенно в случаях отсутствия четкой клинической картины [70]. Авторы выявили значительные различия между первичным и вторичным ФР и акроцианозом (в том числе при системном склерозе) как по исходным ТПВ данным, так и по динамике в фазе разогрева. ...
This review is devoted to the thermographic hands' examination in patients with upper limbs vascular disorders (both arterial and venous), Raynaud’s phenomenon, ischemic heart disease and after surgical interventions on the vessels of the upper extremities, thoracic sympathectomy, as well as a number of more rare diseases and clinical situations. Studies of temperature distributions on the hands of such patients are promising in terms of creating, on their basis, decision support systems in screening, diagnostics and treatment monitoring.
KEY WORDS: thermal imaging, hands, vascular pathology, Raynaud’s phenomenon, cardiovascular pathology.
В данном обзоре обсуждаются тепловизионные феномены на кистях рук различного генеза, в т. ч. при артериальной и венозной патологии верхних конечностей, феномене Рейно, ИБС, после хирургических вмешательств на сосудах верхних конечностей и грудной симпатэктомии, а также ряда редко встречающихся заболеваний и клинических ситуаций. Исследования температурных распределений на кистях рук у пациентов этих нозологических групп перспективны в плане создания на их основе систем поддержки принятия решения в скрининг- диагностике и мониторинге лечения.
КЛЮЧЕВЫЕ СЛОВА: тепловидение, кисти рук, сосудистая патология, феномен Рейно, кардиоваскулярная патология.
... Similar results were obtained in [2,60]. Recent studies explored the possibility to classify RP patients based on their hands' temperature in baseline condition [61,62]. Horikoshi et al. demonstrated that the baseline nail fold temperature was significantly lower in RP patients than in controls [48]. ...
... Horikoshi et al. demonstrated that the baseline nail fold temperature was significantly lower in RP patients than in controls [48]. Martini et al., proved that at baseline, higher temperatures at the distal interphalangeal joint and lower temperatures at metacarpophalangeal joints were observed in PRP compared to the secondary RP [61]. A considerable step forward would be the implementation of a completely automated procedure to avoid the use of a cold challenge and limit human intervention. ...
Raynaud’s phenomenon (RP) is a microvessels’ disorder resulting in transient ischemia. It can be either primary or secondary to connective tissue diseases, such as systemic sclerosis. The differentiation between primary and secondary to systemic sclerosis is of paramount importance to set the proper therapeutic strategy. Thus far, thermal infrared imaging has been employed to accomplish this task by monitoring the finger temperature response to a controlled cold challenge. A completely automated methodology based on deep convolutional neural network is here introduced with the purpose of being able to differentiate systemic sclerosis from primary RP patients by relying uniquely on thermal images of the hands acquired at rest. The classification performance of such a method was compared to that of a three-dimensional convolutional neural network model implemented to classify thermal images of the hands recorded during rewarming from a cold challenge. No significant differences were found between the two procedures, thus ensuring the possibility to avoid the cold challenge. Moreover, the convolutional neural network models were compared with standard feature-based approaches and showed higher performances, thus overcoming the limitations related to the feature extraction (e.g., biases introduced by the operator). Such automated procedures can constitute promising tools for large scale screening of primary RP and secondary to systemic sclerosis in clinical practice.
... Тепловидение оказалось надежным и воспроизводимым методом объективной количественной оценки тяжести заболевания и прогноза его развития с течением времени и в ответ на лечение у детей с патологическим Рисунок 4. Больной Ш., 24 года, диагноз ФР подтвержден капилляроскопией: исходно, 30 с после ХП, 1 мин., 3 мин., 5 мин., 10 мин. периферическим кровообращением, особенно в случаях отсутствия четкой клинической картины [70]. Авторы выявили значительные различия между первичным и вторичным ФР и акроцианозом (в том числе при системном склерозе) как по исходным ТПВ данным, так и по динамике в фазе разогрева. ...
This review is devoted to the thermogaphic hands examination in patients with upper limbs vascular disorders (both arterial and venous), Raynaud’s phenomenon, ischemic heart disease and after surgical interventions on the vessels of the upper extremities, thoracic sympathectomy, as well as a number of more rare diseases and clinical situations. Studies of temperature distributions on the hands of such patients are promising in terms of creating, on their basis, decision support systems in screening, diagnostics and treatment monitoring.
... Infrared thermography is a diagnostic method widely used also in the pediatric field. The usefulness of thermographic evaluation in the pediatric clinical practice was evaluated to manage fractures, musculoskeletal injuries, diagnosis of acute undifferentiated limp and microvascular dysfunction [25][26][27][28][29][30]. ...
Abstract
Objective: To evaluate the reliability of infrared (IR) thermal camera connected to smartphones, already used in medicine for diagnostic purposes, as an easy tool for access screening to pediatric dentistry services. Material and Methods: After the preventive telephone triage, thirty orthodontic patients (7-13 years) underwent temperature measurement in the office with two no-contact IR devices: forehead digital thermometer and thermal-camera connected to a smartphone (reference areas: forehead, inner canthi, ears). Measurements were compared and differences were statistically investigated with T student’s test (p<0.01). Results: Forehead digital thermometer temperatures were superimposable to those recorded in ear areas and inner canthi with the thermal camera connected to a smartphone. Differences were not statistically significant even in comparison between the sexes. Forehead temperature values detected with a thermal camera are lower than those detected with a digital forehead thermometer. Conclusion: Thermal camera on a smartphone could be reliable in measuring body temperature. Mobile thermographic values of ears and inner canthi areas can be used as an alternative to forehead digital thermometer measurements. Further applications in pediatric dentistry of thermography on smartphones should be examined. © 2021, Association of Support to Oral Health Research (APESB). All rights reserved.
Author keywords
Body Temperature; Differential Thermal Analysis; Fever; SARS-CoV-2; Smartphone
... Typically, image processing includes selection of areas of interest and possibly temperature gradients. The use of temperature gradients from acral to more proximal parts of the hand depends on the type of RP in question, as the distal-dorsal difference has been shown to be able to distinguish pRP from RP secondary to SSc [13,30]. However, gradients are not necessarily a good predictor of the condition where structural tissue changes are not a prominent part of the condition such as in VWF [31]. ...
... The advantage of the image processing for both laser Doppler methods and thermographic imaging is that it is easily comprehensible and simple to perform. Although a study suggested systematic differences between observers [12], another study reported a good inter-rater reliability in thermographic imaging [30]. Accordingly, the disadvantages of this type of image processing are the inter-observer difference, the time consumption, and the need for image analysis training. ...
Raynaud’s phenomenon (RP) is characterized by the episodic whitening of the fingers upon exposure to cold. Verification of the condition is crucial in vibration-exposed patients. The current verification method is outdated, but thermographic imaging seems promising as a diagnostic replacement. By investigating patients diagnosed with RP, the study aimed at developing a simple thermographic procedure that could be applied to future patients where verification of the diagnosis is needed. Twenty-two patients with primary RP and 58 healthy controls were examined using thermographic imaging after local cooling of the hands for 1 min in water of 10°C. A logistic regression model was fitted with the temperature curve characteristics to convey a predicted probability of having RP. The characteristics time to end temperature and baseline temperature were the most appropriate predictors of RP among those examined (p = 0.004 and p = 0.04, respectively). The area under the curve was 0.91. The cut-off level 0.46 yielded a sensitivity and specificity of 82% and 86%, respectively. The positive and negative predictive values were 69% and 93%, respectively. This newly developed thermographic method was able to distinguish between patients with RP and healthy controls and was easy to operate. Thus, the method showed great promise as a method for verification of RP in future patients. Trial registration: ClinicalTrials.gov NCT03094910.
... The authors reported an excellent inter-rater agreement for temperature measurement at DIP joints and MCP joint of patients and controls. The results showed also that patients with PRP, SRP and healthy controls present with significant differences in basal finger temperature and in re-warming pattern after cold challenge [434]. ...
The literature survey 2019 is based on 775 papers found in Scopus with the keywords "thermography" OR "infrared imaging" OR "thermology" OR "temperature measurement" OR "thermometry" AND "published in 2019" and restricted to "medicine". The final database was created from 643 articles after 211 badly matched hits were excluded and a total of 79 articles were added, namely publications, notes or abstracts discovered in the journal "Thermology international" or in the author's literature archive. The papers were analysed with respect to the origin of authors, the language and the publication source. Like in the surveys of previous years, a detailed description is provided of publications related to Raynaud's phenomenon, Complex Regional Pain Syndrome, Breast diseases, fever measurement and application in sports. Most of the publications on breast thermography continue to originate from Asia. These papers have their primary focus on image processing and artificial intelligence applications for the evaluation of breast thermograms
