A Pilot Study of Infrared Thermal Imaging to Detect Active Bone Lesions in Children With Chronic Nonbacterial Osteomyelitis

Abstract

Objective. Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease. An inexpensive and rapid imaging tool, infrared thermal imaging, was evaluated for its utility to detect active bone lesions in extremities of children with CNO.Methods. Children with suspected active CNO and healthy controls were enrolled. All subjects underwent infrared thermal imaging of the lower extremities. Patients in the CNO group also received a magnetic resonance imaging (MRI) examination. Hyperintensity within bone marrow on a fluid-sensitive T2-weighted MRI sequence was considered confirmatory for inflammation. Infrared thermal data were analyzed using custom software by dividing the leg below the knee into 3 equal segments longitudinally and adding the distal femur segment as an equal length above the knee. Median and 95th percentile temperatures were recorded for each leg segment. Temperature differences between inflamed and uninflamed segments in all subjects (both intersubject and intrasubject) were evaluated using a linear mixed-effects model.Results. Thirty children in the suspected/known CNO group and 31 healthy children were enrolled. In the healthy control group, males had significantly higher temperature in their lower extremities than females (P < 0.05). There was no difference in temperature detected between inflamed leg segments of patients with CNO versus uninflamed leg segments of the healthy control group. However, within the CNO group, significantly higher temperatures were detected for inflamed versus uninflamed distal tibia/fibula segments (P < 0.01).Conclusion. Children with active CNO lesions in the distal tibia/fibula exhibited higher regional temperatures on average than healthy extremities. Larger studies are warranted to further evaluate the clinical utility of infrared thermal imaging for CNO detection.

Infrared thermal imaging as a screening tool for paediatric wrist fractures

“…Studies have demonstrated that a number of bone and joint pathologies, for example arthritis and osteomyelitis, will affect the skin surface temperature measured at the site (Zhao et al, 2018, Lasanen et al, 2015. A limitation of this study is that the presence of underlying pathologies was not explored and there is therefore the potential that the patients recruited to the study may have had other undiagnosed pathologies, that may have had an effect on the results attained and may have caused an increase of temperature not attributed to the presence of sprain or fracture.…”

Forehead, Temple and Wrist Temperature Assessment of Ethnic Groups using Infrared Technology

“…All volunteers were instructed not to eat heavy meals, smoking, drinking coffee, alcohol, or energetic stimulants for at least two hours prior to data collection [6] . The evaluation room, with a size of 10 m 2 was previously prepared for the acquisition, keeping the volunteer away from incidence sunlight and air flow, as well as electrical wires, to minimize the interference of infrared radiation from external sources [18] . Likewise, only the researcher and the volunteer remained in the room at the time of temperature measurement, thus minimizing the environment temperature change.…”

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

“…The medical room was maintained with a relative air humidity below 60%, assessed by a portable Mimipa ® thermohygrometer, and the ambient temperature, the patient was maintained at a comfort level of 22°C. Clothes covering the region of diagnostic interest were carefully removed and the patient was invited to attend clinical follow-up visits always wearing loose-fitting clothing that did not squeeze the affected limb, Zhao et al 23 The patient was instructed to not have heavy meals, smoke, or drink coffee, alcoholic or energetic stimulants for at least two hours before the appointment. If caffeinated beverages were consumed or antipyretic drugs were administered, the images were not collected during the medical consultation and the patient only underwent radiographic examination.…”