Introduction: The physiological response of the tendon structure has been the subject of several studies using clinical thermography, although the lack of normal values limits clinical practice despite being, according to several authors, an optimal diagnostic tool for the study and therapeutic monitoring of soft tissues. To this end, the aim of this systematic review was to explore all the scientific information on thermography and reference values in the patellar tendon. Method: A search was carried out in different health science databases using the MeSH terms “Health”, “Patellar Ligament”, and “Thermography” with their synonyms in free terms to collect the studies to be included in the systematic review. This review was conducted according with PRISMA guidelines and includes all of the literature up to 19 December 2023. All studies that were in accordance with the PICOS strategy in title and abstract were included in this review, while studies that performed the baseline thermographic test in an altered physiological state were excluded after reading the full text. The TISEM scale was used to assess the quality of the studies; the risk of bias was assessed with the QUADAS-2 scale. Result: A total of 6 articles was selected (n = 148); these were analyzed for quality and found to be highly heterogenous; the risk of bias was low in most domains of the QUADAS-2 scale. Discussion and Conclusion: There are several variabilities that can induce changes in the thermoregulation process distorting the thermograms. Looking deeper into the evidence behind each item, we can deduce the need to follow the TISEM protocol as closely as possible for an accurate response. The heterogeneity in the way the results were provided and the low quality in some of the studies did not allow for a reference of thermographic values to be obtained.
