Infrared thermal imaging in the diagnosis of musculoskeletal injuries: a systematic review and meta-analysis

Accuracy of infrared thermography evaluation in burn wound healing: a systematic review and meta-analysis

OBJECTIVE

Accurate assessment of burn depth and burn wound healing potential is essential to determine early treatments. Infrared thermography (IRT) is a non-invasive and objective tool to do this. This systematic review evaluated the accuracy of IRT to determine burn wound healing potential.

METHOD

This systematic review and meta-analysis used MEDLINE, EMBASE, CINAHL, PEDro, DiTA and CENTRAL databases. IRT data were extracted from primary studies and categorised into four cells (i.e., true positives, false positives, true negatives and false negatives). Subgroup analysis was performed according to methods used to capture thermal images.

RESULTS

The search strategy identified 2727 publications; however, 15 articles were selected for review and 11 for meta-analysis. In our meta-analysis, the accuracy of IRT was 84.8% (63% sensitivity and 81.9% specificity).

CONCLUSION

IRT is a moderately accurate tool to identify burn depth and healing potential. Thus, IRT should be used carefully for evaluating burn wounds.

Acute outcomes of acupuncture and dry needling over peripheral acute fatigue in untrained healthy volunteers: A randomized controlled clinical trial

Peripheral acute fatigue (PAF) is defined as when the skeletal muscle is incapable of generating power. We aimed to investigate the acute effects of traditional Chinese acupuncture (TCA) and dry needling (DN) over PAF induced on the biceps brachii of untrained healthy volunteers. We conducted a randomized, single-blind controlled clinical trial. All volunteers (n = 45) underwent fatigue induction protocols repeated before and after treatment with TCA (TCA group; TCAg; n = 15), DN (DN group; DNg; n = 15), and rest (control group; Cg; n = 15). Assessments of PAF, skin temperature, and exercise time occur before and after each event: 1st fatigue induction (FI), treatment, and 2nd FI. We used repeated measures ANOVA adjusted with Bonferroni post hoc test to determine any change in tested variables (PAF-VAS, PAF-EMG, and skin temperature) at different time points compared to the baseline. Paired Samples t-test was used for the variable exercise times. All statistical tests considered' the significance level at p ≤ 0,05. There was no difference between groups in acute fatigue recovery (p = 0.19). All intragroup analyses were significant (p ≤ 0.05) and all volunteers show a reduction in fatigue perception after treatment (p ≤ 0,05), however, exercise time did not ameliorate after TCA or DN (p > 0.77). A single session of TCA and, DN can equally reduce fatigue, temperature, and exercise time over PAF induced on biceps brachii of untrained healthy volunteers.

Infrared Thermography-A Novel Tool for Monitoring Fracture Healing: A Critically Appraised Topic With Evidence-Based Recommendations for Clinical Practice

CLINICAL SCENARIO

Stress fractures are one of the most common injuries in athletes. Unfortunately, they are hard to diagnose, require multiple radiology exams and follow-up which leads to more exposure to radiation and an increase in cost. Stress fractures that are mismanaged can lead to serious complications and poorer outcomes for the athlete. During the rehabilitation process, it would be beneficial to be able to monitor the healing of fractures to know when it is safe to gradually allow a patient to a return to sport because the return to activity is not usually objective and based on pain level.

CLINICAL QUESTION

Can infrared thermography (IRT) be a useful tool to measure the pathophysiological state of the fracture healing? The aim of this critically appraised topic is to analyze the current evidence of IRT for measuring the temperature change in fractures to provide recommendations for medical practitioners.

SUMMARY OF KEY FINDINGS

For this critically appraised topic, we examined 3 articles that compared medical imaging and IRT over multiple time points during the follow-up. The 3 articles concluded that a 1 °C asymmetry in temperature followed by a return to normal (less than 0.3 °C) temperature during the healing process of fractures can be monitored using IRT.

CLINICAL BOTTOM LINE

Once the patient has been diagnosed with a fracture, IRT can safely be used to monitor the evolution of a fracture. When the thermogram progresses from a hot thermogram to a cold thermogram, the healing is considered good enough to return to sport.

STRENGTH OF RECOMMENDATION

Grade 2 evidence exists to support IRT being used by clinicians to monitor fracture healing. Due to the limited research and novelty of the technology, the current recommendations are for following the treatment of the fracture once the initial diagnosis is made.

Role of Infrared Thermography in Planning and Monitoring of Head and Neck Microvascular Flap Reconstruction

Background

Reconstruction using microvascular free flaps has become the standard of care in head and neck cancer surgery, and their success lies in appropriate planning, adequate revascularization, and early detection of flap compromise so that prompt salvage is possible. This study evaluates the role of infrared thermography in the planning, execution, and postoperative monitoring of microvascular flaps in head and neck reconstructions.

Methods

This is a single institutional, prospective observational study conducted at a tertiary care hospital in South India for 13 months. Twenty patients were included, and their thermographic images were captured in the preoperative, intraoperative, and postoperative settings using the infrared camera FLIR T400. These images were analyzed along with the Doppler, and clinical monitoring findings in all the settings and the temperature difference were calculated postoperatively.

Results

Hotspot perforator marking was made using infrared camera, and perforator marking was made using hand-held Doppler preoperatively, which correlated in 93% of cases. Intraoperatively, flap rewarming was successfully demonstrated in 19 of 20 cases. Postoperatively, flap compromise was observed on infrared thermography during the first 24 hours but not on clinical monitoring in three cases. The temperature difference values recorded were 5.4°C, 2.4°C, and 4.9°C. The mean of temperature difference of the healthy flaps was 1.0°C (range 0.1°C-1.8°C).

Conclusion

Infrared thermography provides simple and reliable imaging, which can be used in perforator marking and flap designing preoperatively and checking the flap perfusion and vascular anastomosis patency intra- and postoperatively.

Comparison and convergence of compartment syndrome techniques: a narrative review

INTRODUCTION

Compartment syndrome (CS) continues to be a legitimate orthopedic emergency as it leads to thousands of amputations and permanent nerve and tissue damage to undiagnosed patients for more than eight hours. In CS, intracompartmental pressure is elevated, causing reduced blood flow inside the limb compartments. An erroneous diagnosis may result in unnecessary fasciotomies, the only treatment for this condition.

AREAS COVERED

This review examines the previous and current diagnostic and therapeutic practices for compartment syndrome. It also performs a comparative analysis of each diagnostic technique and its foresights.

EXPERT OPINION

Currently, most clinicians rely on a physical examination of the patient to diagnose CS. The primary reason for the physical examination is the lack of a gold-standard device. The invasive intracompartmental pressure (ICP) measurement technique is still the most commonly used. On the other hand, many non-invasive approaches have the potential to be used as diagnostic tools; however, more research is needed before they can be accepted as standard clinical approaches.

Infrared thermography for the evaluation of adolescent and juvenile idiopathic scoliosis: A systematic review

INTRODUCTION

Adolescent and Juvenile Idiopathic Scoliosis are a three-dimensional spine deformity characterized by a muscle alteration of the convex and concave sides of the scoliosis, which can be evaluated with different non-invasive and radiation-free methods such as infrared thermography. The objective of the present review is to assess infrared thermography as a potential method to evaluate alterations of the scoliosis.

MATERIALS AND METHODS

A systematic review was performed by collecting articles from PubMed, Web of Science, Scopus, and Google Scholar, published from 1990 to April 2022, on the use of infrared thermography to evaluate adolescent and juvenile idiopathic scoliosis. Relevant data were collected in tables, and the primary outcomes were discussed narratively.

RESULTS

Of the 587 articles selected, only 5 were in line with the objective of this systematic review and were eligible for the inclusion criteria. The findings of the selected articles corroborate the applicability of infrared thermography as an objective method to assess the thermal differences of the muscles between the convex and concave sides of scoliosis. The overall quality of the research was uneven in the reference standard method and assessment of measures.

CONCLUSION

Infrared thermography is providing promising results to discriminate thermal differences in scoliosis evaluation, albeit there are still some concerns about considering it as a diagnostic tool for scoliosis evaluation because specific recommendations for collecting data are not met. We propose additional recommendations to existing guidelines to perform thermal acquisition to reduce errors and provide the best results to the scientific community.

Intra- and inter-session reliability and repeatability of an infrared thermography device designed for materials to measure skin temperature of the triceps surae muscle tissue of athletes

Background

Infrared thermography devices have been commonly applied to measure superficial temperature in structural composites and walls. These tools were cheaper than other thermographic devices used to measure superficial human muscle tissue temperature. In addition, infrared thermography has been previously used to assess skin temperature related to muscle tissue conditions in the triceps surae of athletes. Nevertheless, the reliability and repeatability of an infrared thermography device designed for materials, such as the Manual Infrared Camera PCE-TC 30, have yet to be determined to measure skin temperature of the triceps surae muscle tissue of athletes.

Objective

The purpose was to determine the procedure's intra- and inter-session reliability and repeatability to determine skin temperature within the Manual Infrared Camera PCE-TC 30 thermography device in the triceps surae muscle tissue of athletes, which was initially designed to measure the superficial temperature of materials.

Methods

A total of 34 triceps surae muscles were bilaterally assessed from 17 healthy athletes using the Manual Infrared Camera PCE-TC 30 thermography device to determine intra- (at the same day separated by 1 h) and inter-session (at alternate days separated by 48 h) reliability and repeatability of the skin temperature of the soleus, medial and lateral gastrocnemius muscles. The triceps surae complex weas measured by a region of interest of 1 cm² through five infrared thermography images for each muscle. Statistical analyses comprised intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MCD), systematic error of measurement, correlation (r), and Bland-Altman plots completed with linear regression models (R ²).

Results

Intra- and inter-session measurements of the proposed infrared thermography procedure showed excellent reliability (ICC_(1,2) = 0.968-0.977), measurement errors (SEM = 0.186-0.232 °C; MDC = 0.515-0.643 °C), correlations (r = 0.885-0.953), and did not present significant systematic error of measurements (P > 0.05). Adequate agreement between each pair of measurement moments was presented by the Bland-Altman plots according to the limits of agreement and non-significant linear regression models (R ² = 0.000-0.019; P > 0.05).

Conclusions

The proposed procedure to determine skin temperature within the Manual Infrared Camera PCE-TC 30 thermography device presented excellent intra- and inter-session reliability and repeatability in athletes' triceps surae muscle tissue. Future studies should consider the SEM and MDC of this procedure to measure the skin temperature of soleus, medial, and lateral gastrocnemius muscles to promote triceps surae muscle prevention and recovery in athletes.

Detecting bone lesions in the emergency room with medical infrared thermography

Introduction

Low- to high-energy impact trauma may cause from small fissures up to extended bone losses, which can be classified as closed or opened injuries (when they are visible at a naked eye).

Objective

The aim of this study was to investigate the feasibility of clinical diagnosis of bone trauma through medical infrared thermography, in a hospital emergency room.

Methods

Forty-five patients with suspected diagnosis of bone fracture were evaluated by means of medical infrared images, and the data correlated with the gold standard radiographic images, in the anteroposterior, lateral, and oblique views, at the orthopedic emergency department. The control group consisted of thermal images of the contralateral reference limb of the volunteers themselves. Data were acquired with a medical grade infrared camera in the regions of interest (ROIs) of leg, hand, forearm, clavicle, foot, and ankle.

Results

In all patients evaluated with a diagnosis of bone fracture, the mean temperature of the affected limb showed a positive difference greater than 0.9 °C (towards the contralateral), indicating the exact location of the bone trauma according, while the areas diagnosed with reduced blood supply, showed a mean temperature with a negative variation.

Conclusion

Clinical evaluation using infrared imaging indicates a high applicability potential as a tool to support quick diagnosis of bone fractures in patients with acute orthopedic trauma in an emergency medical setting. The thermal results showed important physiological data related to vascularization of the bone fracture and areas adjacent to the trauma well correlated to radiographic examinations.

Evaluation of Tibia Bone Healing by Infrared Thermography: A Case Study

Background

Thermal imaging has been used as a clinical follow-up technique in several medical specialties.

Purpose

The aim of this study was to investigate the feasibility of using medical thermography in the diagnosis and follow-up assessment of a severe orthopedic trauma that requires the use of an external circular fixator.

Patients and Methods

Twenty clinical follow-ups of thermal imaging correlated with X-ray images were performed in a male volunteer, diagnosed with bone nonunion, during 11 months of treatment, in the hospital trauma and reconstruction department. Data were acquired in the regions of interest of the proximal tibia, diaphysis and distal, with a Flir T530 medical grade infrared camera from Flir Systems^®, and the data processed by the Matlab^® 2019 custom made software.

Results

Statistical analysis was performed by Wilcoxon signed-rank test. The results showed a median temperature of 22.2°C, and thus some periods of interruption in the healing process between the third and twentieth clinical follow-up, and a significant increase of the temperature to 34.6°C synchronous with a diagnosis of bone infection by the eleventh clinical follow-up. The thermal images acquired during the 20 clinical follow-ups allow a correlation with the data from the X-ray exams and also with the contralateral limb of the evaluated patient, showing thermal alterations greater than 0.3°C, which are significant of physiological abnormality.

Conclusion

The thermography exam can be a useful tool for applying on the follow-up of patients after trauma or bone fracture. The results showed important physiological data related to the vascularization necessary for bone repairing, being therefore a good indicator of the healing process. In addition, as infrared thermography does not use ionizing radiation, it can be used countlessly, in complement to the traditional X-ray exams that focus on anatomical data analysis.

Regions of interest selection and thermal imaging data analysis in sports and exercise science: a narrative review

OBJECTIVE

Infrared thermography (IRT) is a non-invasive, contactless and low-cost technology that allows recording of the radiating energy that is released from a body, providing an estimate of its superficial temperature. Thanks to the improvement of infrared thermal detectors, this technique is widely used in the biomedical field to monitor the skin temperature for different purposes (e.g. assessing circulatory diseases, psychophysiological state, affective computing). Particularly, in sports and exercise science, thermography is extensively used to assess sports performance, to investigate superficial vascular changes induced by physical exercise, and to monitor injuries. However, the methods of analysis employed to treat IRT data are not standardized, and hence introduce variability in the results.

APPROACH

This review focuses on the methods of analysis currently used for thermal imaging in sports and exercise science.

MAIN RESULTS

Firstly, the procedures employed for the selection of regions of interest (ROIs) from anatomical body districts are reviewed, paying attention also to the potentialities of morphing algorithms to increase the reproducibility of thermal results. Secondly, the statistical approaches utilized to characterize the temperature frequency and spatial distributions within ROIs are investigated, showing their strengths and weaknesses. Moreover, the importance of employing tracking methods to analyze the temporal thermal oscillations within ROIs is discussed. Thirdly, the capability of employing procedures of investigation based on machine learning frameworks on thermal imaging in sports science is examined.

SIGNIFICANCE

Finally, some proposals to improve the standardization and the reproducibility of IRT data analysis are provided, in order to facilitate the development of a common database of thermal images and to improve the effectiveness of IRT in sports science.

Skin surface infrared thermography in pressure ulcer outcome prognosis

OBJECTIVE

To assess the usefulness of skin surface infrared thermography (SSIT) as a prognostic tool in the treatment of stages III and IV pressure ulcers (PU), with hydrocolloid/hydrogel dressings plus 20 exposures to low-level laser therapy (LLLT), compared with hydrocolloid dressings alone, in a group of long-term bedbound care patients.

METHOD

In this comparative study, participants were randomly assigned to group I: PUs treated with specialist wound dressings and laser therapy, or to group II: PUs treated with specialist wound dressings without laser therapy. Thermal imaging sessions were carried out at the beginning of the study, and after two and four weeks of treatment. Thermal imaging processing was applied to compare percentage differences in the temperature distribution between the groups within selected regions of interest (ROIs). The correlation between the temperature distribution and PU healing was evaluated.

RESULTS

A total of 43 patients took part. In the study, three variants of PU healing were observed: pure healing (H) with minimal granulation; healing with hypergranulation (H+G); and non-healing (NH). Analyses of SSIT-related thermographic patterns revealed their dependence on the course of healing. The percentage of successful PU healing reached 79.2% in group I compared with 73.7% in group II (p<0.05) The dominant variant of healing in Group I was H, while in group II the variants H and H+G were present with equal frequency.

CONCLUSION

Thermal imaging processing allowed comparison of differences in the temperature distribution between the groups within ROIs. Application of LLLT significantly improved the healing process (p<0.05). The clinical significance of this finding should be confirmed with larger studies; however, SSIT may be useful as a prognostic tool during the treatment of PUs, with the ability to predict the course of healing initially, that is independent of LLLT treatment.

An Overview of Thermal Infrared Imaging-Based Screenings during Pandemic Emergencies

Infrared thermal imaging (IRI) is a contact-less technology able to monitor human skin temperature for biomedical applications and in real-life contexts. Its capacity to detect fever was exploited for mass screening during past epidemic emergencies as well as for the current COVID-19 pandemic. However, the only assessment of fever may not be selective for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Hence, novel approaches for IRI data analysis have been investigated. The present review aims to describe how IRI have been employed during the last epidemics, highlighting the potentialities and the limitations of this technology to contain the contagions. Specifically, the methods employed for automatic face recognition and fever assessment and IRI's performances in mass screening at airports and hospitals are reviewed. Moreover, an overview of novel machine learning methods for IRI data analysis, aimed to identify respiratory diseases, is provided. In addition, IRI-based smart technologies developed to support the healthcare during the COVID-19 pandemic are described. Finally, relevant guidelines to fully exploit IRI for COVID-19 identification are defined, to improve the effectiveness of IRI in the detection of the SARS-CoV-2 infection.

ACUTE EFFECT OF SPEED TEST ON THE SKIN TEMPERATURE OF ELITE SOCCER PLAYERS

ABSTRACT Introduction Infrared thermography has been used in several areas, mainly in sports training, and specifically in soccer. Objectives The objectives of the study were to verify the acute effect of a displacement speed test on the skin temperature of elite female soccer players, to observe pre- and post-test thermal asymmetries, and to compare responses in the anterior and posterior regions of lower limbs. Methods Cross-sectional study that evaluated 17 soccer players of the 2018 Brazilian Championship. They were submitted to thermography before and 10 minutes after performing the displacement speed test. Thermographic images were collected using a FLIR® model 8 thermal imager and changes in skin temperature in the anterior and posterior regions of the lower limbs were analyzed, according to the areas of interest. Descriptive statistics were performed and mean and standard deviation of the temperatures of the areas of interest were analyzed. The normality of the data was verified, and then the Student’s t test for normal paired and independent samples and the Mann-Whitney test for non-normal samples were conducted, with p <0.05 being adopted for significance level. Results It was possible to observe that after the test there was an increase in skin temperature in all the regions analyzed, both on the dominant and non-dominant sides (p <0.05). Regarding the analysis of the anterior region, it was possible to observe a higher temperature (p <0.05) in the region of the tibial muscles than in the region of the quadriceps muscles. Conclusion It is concluded that thermography helps to understand the thermal responses of lower limbs after applying the displacement speed test. The study shows that thermographic evaluation can guide the organization of the training session when motor tests have previously been applied, and in the detection of abnormal overloads, helping to prevent injuries. Level of evidence IV; Therapeutic studies - Investigation of treatment results.

Infrared thermography in the diagnosis of musculoskeletal injuries: A protocol for a systematic review and meta-analysis

BACKGROUND

Musculoskeletal injuries (MSDs) have become a major public health problem worldwide. Current diagnosis techniques for MSDs are often associated with radiation exposure, expensive cost, or contraindication. Infrared thermography (IRT) is becoming a proposed tool to assist in diagnosing MSDs, but current evidence is inconclusive. Thus, herein we aimed to evaluate the diagnostic accuracy of IRT for MSDs.

METHODS

We will search EMBASE, MEDLINE, EBSCO, Cochrane Library, SCOPUS, Web of Science, CNKI, SinoMed, and Wangfang. Two researchers will independently screen eligible studies. Study quality will be evaluated based on the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data synthesis will be completed using STATA 14.0 software. A bivariate random-effects analysis will be utilized to estimate the pooled estimation of the diagnostic odds ratio (DOR) and the summary receiver operating characteristics (SROC) curve. Subgroup analyses will be performed to determine heterogeneity sources.

RESULTS

This systematic review and meta-analysis will provide reliable evidence about the diagnostic accuracy of IRT for MSDs.

CONCLUSION

The conclusion of this study will be published in a peer-reviewed journal.

ETHICS AND COMMUNICATION

Given that this is a systematic review of published research, patient consent and ethical approval are not relevant. The findings of this study will be disseminated through conference presentations and publication in peer-reviewed journals.

PROSPERO REGISTRATION NUMBER

CRD42020184867.

Thermographic camera in traumatology, diabetic foot and reconstructive procedures

Traumatic lacerations, burns and ulcerations are a common cause of admission in the plastic surgery wards. Clinical evaluation alone sometimes provides insufficient or even inaccurate information. Thermographic camera is a new tool that could provide additional information regarding skin vascularization, presence of inflammation or involvement of deep tissue. A prospective study was realized for assessing pre and postoperative status of patients with lacerations, trauma, burn and diabetic foot. Preoperative evaluation helped in assessing bone involvement, inflammation and infection in order to decide the necessity of surgery. Postoperative evaluation was useful in preventing and lowering the rate of complications. Thermographic camera could be a new helpful and non-invasive tool especially in emergency hospitals in order to assess rapidly and objectively wound status and to start if necessary, a surgical treatment.

Muscular Strength Imbalances Are not Associated with Skin Temperature Asymmetries in Soccer Players

Although strength imbalances using isokinetic dynamometer have been examined for injury risk screening in soccer players, it is very expensive and time-consuming, making the evaluation of new methods appealing. The aim of the study was to analyze the agreement between muscular strength imbalances and skin temperature bilateral asymmetries as well as skin temperature differences in the hamstrings and quadriceps. The skin temperature of the anterior and posterior thigh of 59 healthy male soccer athletes was assessed at baseline using infrared thermography for the identification of hamstrings-quadriceps skin temperature differences and thermal asymmetries (>0.5 °C). Subsequently, concentric and eccentric peak torque of the quadriceps and hamstrings were considered in the determination of the ratios, as well as muscular asymmetries (>15%). When considering the torque parameters, 37.3% (n = 22) of the players would be classified as high risk for injuries. The percentage of those presenting skin temperature imbalances superior to 0.5 °C was 52.5% (n = 31). The skin temperature assessment showed sensitivity (22%) and specificity (32.2%) to identify torque asymmetries, demonstrating the inability to identify false negatives (15.3%) and false positives (30.5%) from all soccer athletes. In conclusion, skin temperature differences between hamstrings and quadriceps could be more related to thermoregulatory factors than strength imbalances.

Occupational Risk Evaluation Through Infrared Thermography: Development and Proposal of a Rapid Screening Tool for Risk Assessment Arising from Repetitive Actions of the Upper Limbs

Risk analysis is one of the main tools for preventing the occurrence of Work-Related Musculoskeletal Disorders. New methods of risk analysis should seek to be more agile and simplified, encouraging them to be widely applied in work environments. This paper aimed to develop a rapid tool for assessing the risk of developing Work-Related Musculoskeletal Disorders (WMSDs) arising from repetitive actions of the upper limbs, while using a thermographic camera to measure skin temperature variation. A workstation was developed in an environmentally controlled laboratory, representing the five levels of risk presented by the Occupational Repetitive Actions Index (OCRA) Index, which were performed by 32 participants for 20 min. each level. There was a significant change in forearm skin temperature at all risk levels (p < 0.001), with a positive linear correlation (r = 0.658 and p < 0.001), which led the authors to perform linear regression analysis for the forearm region. The Predicted OCRA Index calculation equation was successfully developed (R = 0.767 and R² = 0.588), while using as independent variables: air temperature and temperature variation of the forearm skin. The Predicted OCRA Index can be applied as a screening tool for large numbers of workers in the same company or sector, due to its speed of application and the determination of risk level, but it does not replace the original OCRA Index.

La termografía infrarroja como herramienta efectiva para detectar áreas músculares dañadas después de correr una maratón

Introducción. La termografía infrarroja (TI) es un equipo de imagen que capta las radiaciones de calor emitidas por los cuerpos y las recoge en valores de temperatura. En el ámbito deportivo se utiliza para identificar daños en estructuras músculo-esqueléticas a partir de la variación de la temperatura corporal en zonas anatómicas afectadas.Objetivo. Valorar la efectividad de la TI como herramienta para detectar músculos dañados después de correr una maratón.Materiales y métodos. Se evaluaron 17 corredores antes y después de correr una maratón (42.196 km) utilizando un equipo termográfíco.Resultados. Se encontraron diferencias estadísticamente significativas entre la temperatura previa y posterior a correr una maratón. Se presentó una diferencia entre la medición previa y posterior >1°C en el vasto lateral, vasto medial, recto femoral y aductor de la pierna dominante, lo que, basados en parámetros clínicos, representa un daño en estos músculos. Los aumentos de temperatura se mostraron de manera heterogénea entre las zonas anatómicas.Conclusiones. La TI es una herramienta efectiva para detectar zonas musculares dañadas en corredores después de participar en una maratón.

Extracorporeal Shock Wave Stimulation as Alternative Treatment Modality for Wrist and Fingers Spasticity in Poststroke Patients: A Prospective, Open-Label, Preliminary Clinical Trial

Objective. To evaluate the effectiveness of radial shock waves (rESW) for wrist and fingers flexors spasticity in stroke patients. Methods. Twenty patients with upper limb muscle spasticity were enrolled in the study and treated with a single session of rESW. The spasticity level of the radio carpal (RC) and finger (FF) joints was assessed using Modified Ashworth Scale (MAS). The resting bioelectrical activity of the flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU) was examined using surface electromyography (sEMG). Trophic conditions were measured using infrared thermal (IRT) imaging. All measurements were conducted at baseline (t₀), immediately after rESW (t₁), and 1 (t₂) and 24 (t₃) hours following rESW. Results. Significant reduction in MAS was observed for the RC joint in t₁, as well as for the FF joints in t₁, t₂, and t₃. A significant decrease in sEMG was shown for the FCR muscle in t₁ and t₂, as well as for the FCU muscle in t₁ and t₃. Also, a significant increase in IRT value was observed in t₃ only. Conclusions. A single session of rESW could be an effective alternative treatment for reduction of limb spasticity and could lead to improvement of trophic conditions of the spastic muscles.

A facile synthesis of versatile Cu2-xS nanoprobe for enhanced MRI and infrared thermal/photoacoustic multimodal imaging

A novel type of intelligent nanoprobe by using single component of Cu2-xS for multimodal imaging has been facilely and rapidly synthesized in scale via thermal decomposition followed by biomimetic phospholipid modification, which endows them with uniform and small nanoparticle size (ca.15 nm), well phosphate buffer saline (PBS) dispersity, high stability, and excellent biocompatibility. The as-synthesized Cu2-xS nanoprobes (Cu2-xS NPs) are capable of providing contrast enhancement for T1-weighted magnetic resonance imaging (MRI), as demonstrated by the both in vitro and in vivo imaging investigations for the first time. In addition, due to their strong near infrared (NIR) optical absorption, they can also serve as a candidate contrast agent for enhanced infrared thermal/photoacoustic imaging, to meet the shortfalls of MRI. Hence, complementary and potentially more comprehensive information can be acquired for the early detection and accurate diagnosis of cancer. Furthermore, negligible systematic side effects to the blood and tissue were observed in a relatively long period of 3 months. The distinctive multimodal imaging capability with excellent hemo/histocompatibility of the Cu2-xS NPs could open up a new molecular imaging possibility for detecting and diagnosing cancer or other diseases in the future.

Infrared thermography is useful for ruling out fractures in paediatric emergencies

Musculoskeletal injuries are a leading cause of paediatric injuries and emergency department visits in Western countries. Diagnosis usually involves radiography, but this exposes children without fractures to unnecessary ionising radiation. We explored whether infrared thermography could provide a viable alternative in trauma cases. We compared radiography and thermal images of 133 children who had been diagnosed with a trauma injury in the emergency unit of a Spanish hospital. As well as the thermal variables in the literature, we introduced a new quantifier variable, the size of the lesion. Decision tree models were built to assess the technique's accuracy in diagnosing whether a bone had been fractured or not. Infrared thermography had a sensitivity of 0.91, a specificity of 0.88 and a negative predictive value of 0.95. The new lesion size variable introduced appeared to be of main importance to the discriminatory power of the method.

CONCLUSION

The high negative predictive value of infrared thermography suggests that it is a promising method for ruling out fractures.