Thermographic patterns of the upper and lower limbs: baseline data

Alfred Gatt, Cynthia Formosa, Kevin Cassar, Kenneth P Camilleri, Clifford De Raffaele, Anabelle Mizzi, Carl Azzopardi, Stephen Mizzi, Owen Falzon, Stefania Cristina, Nachiappan Chockalingam, Alfred Gatt, Cynthia Formosa, Kevin Cassar, Kenneth P Camilleri, Clifford De Raffaele, Anabelle Mizzi, Carl Azzopardi, Stephen Mizzi, Owen Falzon, Stefania Cristina, Nachiappan Chockalingam

Abstract

Objectives. To collect normative baseline data and identify any significant differences between hand and foot thermographic distribution patterns in a healthy adult population. Design. A single-centre, randomized, prospective study. Methods. Thermographic data was acquired using a FLIR camera for the data acquisition of both plantar and dorsal aspects of the feet, volar aspects of the hands, and anterior aspects of the lower limbs under controlled climate conditions. Results. There is general symmetry in skin temperature between the same regions in contralateral limbs, in terms of both magnitude and pattern. There was also minimal intersubject temperature variation with a consistent temperature pattern in toes and fingers. The thumb is the warmest digit with the temperature falling gradually between the 2nd and the 5th fingers. The big toe and the 5th toe are the warmest digits with the 2nd to the 4th toes being cooler. Conclusion. Measurement of skin temperature of the limbs using a thermal camera is feasible and reproducible. Temperature patterns in fingers and toes are consistent with similar temperatures in contralateral limbs in healthy subjects. This study provides the basis for further research to assess the clinical usefulness of thermography in the diagnosis of vascular insufficiency.

Figures

Figure 1
Figure 1
A diagram showing data capture, with the participant lying supine while a thermographic image of the plantar surface was taken. The angle of measurement was kept approximately perpendicular to the plane of acquisition.
Figure 2
Figure 2
Participants were asked to keep their feet momentarily in slight dorsiflexion and pointing vertically upwards, while a thermal image (a) and a visual image (b) were acquired. Measurement regions were then annotated on the thermal image (a) for further analysis.
Figure 3
Figure 3
Participants were asked to hang their legs over the edge of the couch, with their feet held momentarily in slight plantarflexion, while a thermal image (a) and a visual image (b) were acquired. Measurement regions were then annotated on the thermal image (a) for further analysis.
Figure 4
Figure 4
Participants were asked to spread the palms and fingers of each hand in front of the cameras one at a time, while a thermal image (a) and a visual image (b) were acquired. Measurement regions were then annotated on the thermal images (a) for further analysis.
Figure 5
Figure 5
The mean thermographic temperature of each region (green dot) and the standard deviation across subjects for each region (red bars).
Figure 6
Figure 6
Matrix of the participant-averaged thermographic temperature mean differences between each region-pair.
Figure 7
Figure 7
Matrix of the standard deviations of the participant-averaged thermographic temperature mean differences between each region-pair.

References

    1. Lahiri B. B., Bagavathiappan S., Jayakumar T., Philip J. Medical applications of infrared thermography: a review. Infrared Physics and Technology. 2012;55(4):221–235. doi: 10.1016/j.infrared.2012.03.007.
    1. Benbow S. J., Chan A. W., Bowsher D. R., Williams G., Macfarlane I. A. The prediction of diabetic neuropathic plantar foot ulceration by liquid-crystal contact thermography. Diabetes Care. 1994;17(8):835–839. doi: 10.2337/diacare.17.8.835.
    1. Vinik A. I., Maser R. E., Mitchell B. D., Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26(5):1553–1579. doi: 10.2337/diacare.26.5.1553.
    1. Armstrong D. G., Lavery L. A., Liswood P. J., Todd W. F., Tredwell J. A. Infrared dermal thermometry for the high-risk diabetic foot. Physical Therapy. 1997;77(2):169–177.
    1. Jones B. F., Plassmann P. Digital infrared thermal imaging of human skin. IEEE Engineering in Medicine and Biology Magazine. 2002;21(6):41–48. doi: 10.1109/memb.2002.1175137.
    1. Barriga E. S., Chekh V., Carranza C., et al. Computational basis for risk stratification of peripheral neuropathy from thermal imaging. Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC '12); 2012; pp. 1486–1489.
    1. Sherman R. A., Woerman A. L., Karstetter K. W. Comparative effectiveness of videothermography, contact thermography, and infrared beam thermography for scanning relative skin temperature. Journal of Rehabilitation Research and Development. 1996;33(4):377–386.
    1. Ring E., Jung A., Zuber J. New opportunities for infrared thermography in medicine. Acta Bio-Optica et Informatica Medica. 2009;15:28–30.
    1. Lavery L. A., Armstrong D. G. Temperature monitoring to assess, predict, and prevent diabetic foot complications. Current Diabetes Reports. 2007;7(6):416–419. doi: 10.1007/s11892-007-0069-4.
    1. Spence V. A., Walker W. F., Troup I. M., Murdoch G. Amputation of the ischemic limb: selection of the optimum site by thermography. Angiology. 1981;32(3):155–169. doi: 10.1177/000331978103200302.
    1. Bagavathiappan S., Philip J., Jayakumar T., et al. Correlation between plantar foot temperature and diabetic neuropathy: a case study by using an infrared thermal imaging technique. Journal of Diabetes Science and Technology. 2010;4(6):1386–1392. doi: 10.1177/193229681000400613.
    1. Formosa C., Cassar K., Gatt A., et al. Hidden dangers revealed by misdiagnosed peripheral arterial disease using ABPI measurement. Diabetes Research and Clinical Practice. 2013;102(2):112–116. doi: 10.1016/j.diabres.2013.10.006.
    1. Hildebrandt C., Raschner C., Ammer K. An overview of recent application of medical infrared thermography in sports medicine in Austria. Sensors. 2010;10(5):4700–4715. doi: 10.3390/s100504700.
    1. Bharara M., Cobb J. E., Claremont D. J. Thermography and thermometry in the assessment of diabetic neuropathic foot: a case for furthering the role of thermal techniques. The International Journal of Lower Extremity Wounds. 2006;5(4):250–260. doi: 10.1177/1534734606293481.
    1. Lavery L. A., Higgins K. R., Lanctot D. R., et al. Home monitoring of foot skin temperatures to prevent ulceration. Diabetes Care. 2004;27(11):2642–2647. doi: 10.2337/diacare.27.11.2642.
    1. Armstrong D. G., Holtz-Neiderer K., Wendel C., Mohler M. J., Kimbriel H. R., Lavery L. A. Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients. The American Journal of Medicine. 2007;120(12):1042–1046. doi: 10.1016/j.amjmed.2007.06.028.
    1. Sun P.-C., Jao S.-H. E., Cheng C.-K. Assessing foot temperature using infrared thermography. Foot and Ankle International. 2005;26(10):847–853.
    1. Ring F. Thermal imaging today and its relevance to diabetes. Journal of Diabetes Science and Technology. 2010;4(4):857–862. doi: 10.1177/193229681000400414.
    1. Bouzida N., Bendada A., Maldague X. P. Visualization of body thermoregulation by infrared imaging. Journal of Thermal Biology. 2009;34(3):120–126. doi: 10.1016/j.jtherbio.2008.11.008.
    1. Vainer B. G. FPA-based infrared thermography as applied to the study of cutaneous perspiration and stimulated vascular response in humans. Physics in Medicine and Biology. 2005;50(23):R63–R94. doi: 10.1088/0031-9155/50/23/r01.
    1. Niu H.-H., Lui P.-W., Hu J. S., et al. Thermal symmetry of skin temperature: normative data of normal subjects in Taiwan. Zhonghua Yi Xue Za Zhi. 2001;64(8):459–468.
    1. Uematsu S. Symmetry of skin temperature comparing one side of the body to the other. Thermology International. 1985;1:4–7.
    1. Uematsu S. Thermographic imaging of cutaneous sensory segment in patients with peripheral nerve injury. Skin temperature stability between sides of the body. Journal of Neurosurgery. 1985;62(5):716–720. doi: 10.3171/jns.1985.62.5.0716.
    1. Uematsu S., Edwin D. H., Jankel W. R., Kozikowski J., Trattner M. Quantification of thermal asymmetry. Part 1: normal values and reproducibility. Journal of Neurosurgery. 1988;69(4):552–555. doi: 10.3171/jns.1988.69.4.0552.
    1. World Medical Association. Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects. 2013.
    1. Norgren L., Hiatt W. R., Dormandy J. A., Nehler M. R., Harris K. A., Fowkes F. G. R. Inter-society consensus for the management of peripheral arterial disease (TASC II) Journal of Vascular Surgery. 2007;45(1, supplement):S57–S67. doi: 10.1016/j.jvs.2006.12.037.
    1. Aboyans V., McClelland R. L., Allison M. A., et al. Lower extremity peripheral artery disease in the absence of traditional risk factors. The Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2011;214(1):169–173. doi: 10.1016/j.atherosclerosis.2010.10.011.
    1. Westermann S., Buchner H. H. F., Schramel J. P., Tichy A., Stanek C. Effects of infrared camera angle and distance on measurement and reproducibility of thermographically determined temperatures of the distolateral aspects of the forelimbs in horses. Journal of the American Veterinary Medical Association. 2013;242(3):388–395. doi: 10.2460/javma.242.3.388.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner