What is Thermography?

 

   

 

Thermography is Non invasive, No Radiation, Painless, No Contact with the body & is FDA registered.

Thermography Screening services include: Breast, Upper Body, Full Body, ROI (region of interest)

 

What is Digital Infrared Thermal Imaging or DITI?

Medical DITI, Digital Infrared Thermal Imaging, is a noninvasive diagnostic technique that allows the examiner to visualize and quantify changes in skin surface temperature. An infrared scanning device is used to convert infrared radiation emitted from the skin surface into electrical impulses that are visualized in color on a monitor. This visual image graphically maps the body temperature and is referred to as a thermogram. The spectrum of colors indicate an increase or decrease in the amount of infrared radiation being emitted from the body surface. Since there is a high degree of thermal symmetry in the normal body, subtle abnormal temperature asymmetry's can be easily identified. 

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Breast Screening Procedure

This procedure is totally painless, there is no compression or contact with the body. The test is non invasive, uses no radiation, and is F.D.A registered.


- Annual breast thermography screening for women of all ages. 
- Mammography, when considered appropriate for women who are aged 50 or older.
- A regular breast examination by a health professional.
- Monthly breast self-examination. 
- Personal awareness for changes in the breasts.
- Readiness to discuss quickly any such changes with a doctor. 

These guidelines should be considered along with your background and medical history.

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Case Studies

 Thermography Case Studies

case 1

Complex Regional Pain Syndrome right foot, significant increase in sympathetic motor tone right foot 3.7°c colder than left foot. A cold stress test was positive, (no sympathetic change).

CRPS developed in the right foot after a fractured calcaneus 18 months previously. Weight bearing was painful. The diagnosis of CRPS was missed initially since nuclear imaging was not typical of CRPS.

Some cases of CRPS are misdiagnosed as psychological or hysterical pain states. Thermography is able to show characteristic changes if utilised.

 

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case 4case 3case 2

A 32 year old housewife and mother presented with acute back pain with right L2 and L3 sensory and motor nerve root involvement.

Thermography confirmed right L2/L3 root irritation and myelography and CT scan showed a large right L2/L3 prolapse with L4/L5 root involvement.

Thermography shows excellent correlation with CT, MRI and Myelography in radiculopathy.

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case 5case 6case 7

Right knee surgery was followed with a painful effusion in the early post operative period.

Thermography confirmed a significant inflammatory reaction. 30cc of blood-stained fluid was aspirated.

Thermography can quantify all grades of joint synovitis and is able to demonstrate minimal changes due to NSAID’s
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case 8

Post-Traumatic Complex Regional Pain Syndrome. A 34 year old female supermarket worker injured her left wrist 3 years previously. There were typical features of CRPS including severe persistent pain and colour and temperature changes in the left wrist and hand.

There was a good initial response to a right cervical sympathectomy but a year later symptoms returned. Treatment with I.V. Guanethidine gave some relief and reduced the temperature differentials significantly from a deltaT of 6.2°c pre treatment to 0.8°c post treatment.

Thermographic monitoring of sympathetic blockade provides useful objective data to quantify effectiveness of previous blockade and prospective treatments.

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case 9

A 28 year old male carpet layer presented with a clinical left carpal tunnel syndrome, The EMG was normal but the left median sensory nerve latency and amplitude suggested minimal dysfunction relative to the right side. Thermography during sympathetic challenge (cold stress test) showed sympathetic nerve dysfunction consistent with an early left carpal tunnel syndrome.

Thermographic sensitivity for detection of early carpal tunnel syndrome is improved by cold stressing both hands. Sympathetic nerve fibres in the symptomatic median nerve are hyperirritable producing a sustained response during cold stress.

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©Copyright 1997 - 2011 by Meditherm, Inc. All rights reserved.

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Detectable Conditions

Indications for Thermographic Evaluation

 

 Altered Ambulatory Kinetics, Altered Biokinetics, Arteriosclerosis, Brachial Plexus Injury, Biomechanical Impropriety

 Breast Disease, Bursitis, Carpal Tunnel Syndrome, Causalgia, Compartment Syndromes, Cord Pain/Injury

 Deep Vein Thromosis, Disc Disease, Disc Syndromes, Dystrophy, External Carotid Insufficiency, Facet Syndromes

 Grafts, Hysteria, Headache Evaluation, Herniated Disc, Herniated Nucleus Pulposis, Hyperaesthesia, Hyperextension Injury,

Hyperflexion Injury, Inflammatory Disease, Internal Carotid Insufficiency, Infectious Disease (Shingles, Leprosy)

 Lumbosacral Plexus Injury, Ligament Tear, Lower Motor Neuron Disease, Malingering, Median Nerve Neuropathy

 Morton's Neuroma, Myofascial Irritation, Muscle Tear, Musculoligamentous Spasm, Nerve Entrapment, Nerve Impingement

 Nerve Pressure, Nerve Root Irritation, Nerve Stretch Injury, Nerve Trauma, Neuropathy, Neurovascular Compression

 Neuralgia, Neuritis, Neuropraxia, Neoplasia (melanoma, squamous cell, basal), Nutritional Disease (Alcoholism,Diabetes)

 Peripheral Nerve Injury, Peripheral Axon Disease, Raynaud’s, Referred Pain Syndrome, Reflex Sympathetic Dystrophy

 Ruptured Disc, Somatization Disorders, Soft Tissue Injury, Sprain/Strain, Stroke Screening, Synovitis, Sensory Loss

 Sensory Nerve Abnormality, Somatic Abnormality, Superficial Vascular Disease, Skin Abnormalities, Thoracic Outlet Syndrome

 Temporal Arteritis, Trigeminal Neuralgia, Trigger Points, TMJ Dysfunction, Tendonitis, Ulnar Nerve Entrapment, Whiplash

 

Copyright © 2002-2009, American College of Clinical Thermography

 

 

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Sports Medicine

Digital Infrared Thermal Imaging in Sports Medicine and Musculoskeletal Disorders

 

DITI has been shown to be useful as a diagnostic tool in the differential diagnosis of neuromusculoskeletal injuries and their prognosis for return to participation and/or competition. 

Since DITI is noninvasive, risk-free, and relatively portable, it is a very practical tool in the clinical setting and may be used in the sports medicine clinic, private practice or the training room to assess injury and make clinical decisions. 

DITI not only helps confirm a diagnosis, but can be used as a gauge to clinically assess progress and treatment response, as well as a rognostic indicator. 

DITI is useful for, but not limited to, the diagnosis and evolution of epicondylitis, patellofemoral syndromes, ankle injuries, shin splints, stress fractures, myofascial pain syndromes, spinal pain syndromes, shoulder injuries, foot pain syndromes, and vascular disorders. One of DITI's biggest contributions to sports medicine is in the detection of the post traumatic pain syndromes of reflex sympathetic dystrophy (complex regional pain syndrome) and sympathetic maintained pain syndromes which can occur after minimal injury. These have traditionally been difficult to diagnose. DITI provides an invaluable window into the autonomic/sympathetic nervous system, which records via somatocutaneous reflex, the sympathetic response to pain and injury.

The controlling mechanism for thermal emission and dermal microcirculation is the sympathetic nervous system. There is a persistent vasomotor tone in the peripheral arterioles and precapillary sphincters. This tone allows the dermal vessels to stay in a partially constricted state so as to inhibit excess heat loss from a higher core temperature. The autonomic regulation involves synapse of preganglionic sympathetic fibres to postganglionic. The postganglionic fibres travel to vascular structures and modulate alpha receptor function in the dermal microcirculation. When there is increased sympathetic function vasospasm will occur due to further vessel constriction and there will be decreased thermal emission at the cutaneous level. This may occur due to either increased postganglionic fibres function/irritation or hypersensitization of the alpha receptors in the dermal microcirculation allowing increased binding of catecholamines. Increased thermal emission will conversely be seen due to situations of decreased postganglionic function (such as seen in denervation) or alpha receptor blockade (receptor fatigue due to release of vasoactive substances such as substance P) . 

Muscle, joint, osseous, ligament and nerve injuries all cause the patient to perceive pain. Pain sensation is carried by afferent stimulation of C-nociceptors. These unmyelinated fibres do have a percentage of sympathetics. Pain is then processed centrally and up to the brain via the spinothalamic tracts. The patient may feel pain at the area of injury and at sites distant to the area of injury. This is called referred pain. Much research has been done documenting referred pain in myofascial syndromes and somatic visceral conditions. These referred pain zones are believed to be a somatocutaneous sympathetic response. They work via a common autonomic neural network. The somatosympathetic response can be imaged by DITI. Pain is believed to be a neurogenic and autonomic response to injury and DITI findings have been found to correlate well to the patient's report of painful areas and is well suited for diagnostic purposes in athletic injuries. DITI is not a picture of pain, however it is a picture of autonomic dysfunction which seems to correlate well with regions of pain.

Pain felt at the area of injury is generally seen to be hyperthermic (increased thermal emission) due to decreased sympathetic function and alpha receptor blockade from posttraumatic metabolic by-products such as substance P, kinins, histamines, etc. This could be called a somatocutaneous reflex.

Areas of referred pain are generally seen to be hypothermic (decreased thermal emission) due to increased sympathetic function.

DITI has been recognised as a viable diagnostic tool since 1987 by the AMA council on scientific affairs, the ACA council on Diagnostic Imaging, the Congress of Neurosurgeons in 1988 and in 1990 by the American Academy of Physical Medicine and Rehabilitation. A number of studies have been done to determine DITI’s interexaminer reliability and validity. A study of DITI in low back pain patients found 96% interobserver reliability. In a study of patients with knee pain, 98% test efficiency and 94% interrater reliability was found. 

DITI has good clinical utility, is cost effective, risk-free and provides instantaneous real time imaging. DITI should be used by doctors treating common disorders for diagnostic and assessment purposes. While many doctors do not own diagnostic equipment, most major cities and suburban areas have experienced thermographers that will give the referring doctor access to this useful technology and diagnostic test. Major medical centre hospitals should have a thermal imaging department available for referral, and it is hoped that now medical DITI has become more economic it will allow Doctors to maximise their specialist skills through access to this objective test of physiology and ultimately benefit their patients.

 

©Copyright 1997 - 2011 by Meditherm, Inc. All rights reserved.

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