Thermal imaging helps provide a response plan
For Workers & Corporations
S D Sharma, Research Fellow, E M Smith, Research Nurse, B L Hazleman, Consultant Rheumatologist,J R Jenner, Consultant Rheumatologist
Research Unit, Box 194, Cambridge CB2 2QQ, b
Addenbrookes NHS Trust, Cambridge CB2 2QQ
Chronic incapacitating forearm pain and disability in the context of repetitive action has caused much debate. Lack of objective measurements in a condition with diverse symptoms, few physical signs, and uncertain pathology is a major problem. Clinical observations have suggested the presence of vasomotor changes in repetitive strain injury, so we used computer assisted thermography to assess this.
that thermography needs further evaluation as a
diagnostic tool in evaluating repetitive strain
injury. It may prove more useful in follow up,
particularly in measuring response to treatment, some
of which has been prescribed at enormous cost and with
little evidence of benefit.
the detection of carpal tunnel
RT, Herrick SK
conducted using liquid crystal thermography
(FlexiTherm) and electronic thermography for the
diagnosis of carpal tunnel syndrome. Studies were also
conducted to differentiate carpal tunnel syndrome from
peripheral neurovascular injuries. Ninety patients
were included in the study, with an average follow-up
time of 24 months. Fifty patients also had electric
studies for comparison and contrast. Thermal
patterns of carpal tunnel syndrome showed a
decreased vascular heat emission pattern over the
median nerve distribution. The procedures using
thermography consisted of imaging of the cervical
spine, shoulders, forearms, and hands. Results of the
studies showed that thermographic studies were
efficacious and sensitive for the differential
diagnosis of carpal tunnel syndrome from other
peripheral compressive neuropathies, including
cervical radiculitis, thoracic outlet syndrome,
cubital tunnel syndrome, and Guyon's canal syndrome.
Biomechanic and etiologic factors indict carpal tunnel
syndrome to be an occupational disease. Thermographic
technique use may lead to the early diagnosis,
treatment, and preventative measures that could
eliminate the high cost of manpower loss and of
medical care often
unilateral carpal tunnel
Costich JF, Burgess RC, Wexler CE
was undertaken to assess the sensitivity and
specificity of thermographic diagnosis of unilateral
carpal tunnel syndrome in a patient population large
enough to permit meaningful statistical analysis.
Sixty-one persons with clinical diagnoses of
unilateral carpal tunnel syndrome confirmed by
electrodiagnostic examination and 40 symptom-free
volunteers underwent standard thermographic
examinations. The thermographic images were then
randomly sorted and interpreted by an experienced
physician thermographer. Fifty-seven of the 61
patients with carpal tunnel syndrome were found to
have thermographic abnormalities, while only one of
the control group was found to have such an
abnormality. Individual area sensitivity was highest
in the dorsal area, but addition of other regions
increased this measure; specificity ranged between 98%
and 100%. These findings would appear to confirm
the value of thermography in the diagnosis of
unilateral carpal tunnel syndrome.
the diagnosis of respiratory organ
A thermographic study of the chest was of importance in the diagnosis and differential diagnosis of pneumoconiosis, chronic dust-induced bronchitis, unspecific pulmonary diseases. This could substitute traditional methods of examination. Results make it possible to recommend the method of thermography in the diagnosis of professional diseases as well as in periodic prophylactic screenings of coal miners.
[Thermographic signs of forearm myopathies in industrial workers].
authors described thermographic sign of forearm
myopathy similar to RSI in industrial workers. The
sign is that upper third of the forearm has skin
temperature higher by over 0.3 degree C (for
associated cervical osteochondrosis--by over 0.5
degree C) as lower third of the forearm. The
temperature gradient (up to 2.5 degrees C) appeared
to correlate with more marked myopathy.
[Automated diagnosis of vibration disease].
Based on a
multidimensional discriminant analysis of the
clinical and physiological characteristics derived
as a result of examination of 593 miners,
classification functions were plotted, allowing the
diagnosis of vibratory disease in the automatic mode
by means of mathematic computations. Functional
indicators of skin sensitivity, particularly
vibratory, dynamometry, rheovasography and thermography
of the hand and fingers, a "white spot"
symptom, and characteristics derived on a
analysis of heart rhythm were established to be
informative for automated diagnosis. The diagnosis
was found to be more accurate in case of using a
two-stage variant of the discriminant analysis where
the differentiation is first made between healthy
workers and workers with a pathology, followed by
the discrimination of the preclinical and clinical
phase of the disease. The automated diagnostic
system is demonstrated to compare very favourably
with the conventional method of diagnosis.
of thermal tests for evaluating vascular changes
investigations have been carried out on 40 workers
of an industrial factory. Twenty workers used
vibration tools, the others, having no contact with
vibration, constituted the control group. Each
subject had his skin temperature measured at 19
points of the left and right hands at ambient
temperature of 22 degrees C and after cooling at 15
degrees C and 8 degrees C. The results have
demonstrated that early vasomotor changes are best
identified by the thermal test with cooling
at 8 degrees C. Furthermore, this method enables a
topographic estimation of the hand areas for special
risk of the disturbances in blood vessels of workers
using vibration tools.
Normal thermographic standards for the cervical spine and upper extremities.Although thermography has been used for a variety of abnormal conditions, extensive data on large, relatively asymptomatic populations has heretofore not been available. More specifically, no data deal with the upper extremities and, more particularly, no analyses are based on simultaneous thermograms of the posterior neck and shoulders. The current study undertook this task. The results confirm the existence of thermal symmetry in the overwhelming majority of 100 normal relatively asymptomatic, actively employed factory workers. Conversely,if persistent, statistically significant thermal asymmetry exists, as outlined and correlates with patient symptomatology, an organic basis for it should be sought.
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