Detecting bone lesions in the emergency room with medical infrared thermography

Abstract

Introduction: Low- to high-energy impact trauma may cause from small fissures up to extended bone losses, which can be classified as closed or opened injuries (when they are visible at a naked eye).

Objective: The aim of this study was to investigate the feasibility of clinical diagnosis of bone trauma through medical infrared thermography, in a hospital emergency room.

Methods: Forty-five patients with suspected diagnosis of bone fracture were evaluated by means of medical infrared images, and the data correlated with the gold standard radiographic images, in the anteroposterior, lateral, and oblique views, at the orthopedic emergency department. The control group consisted of thermal images of the contralateral reference limb of the volunteers themselves. Data were acquired with a medical grade infrared camera in the regions of interest (ROIs) of leg, hand, forearm, clavicle, foot, and ankle.

Results: In all patients evaluated with a diagnosis of bone fracture, the mean temperature of the affected limb showed a positive difference greater than 0.9 °C (towards the contralateral), indicating the exact location of the bone trauma according, while the areas diagnosed with reduced blood supply, showed a mean temperature with a negative variation.

Conclusion: Clinical evaluation using infrared imaging indicates a high applicability potential as a tool to support quick diagnosis of bone fractures in patients with acute orthopedic trauma in an emergency medical setting. The thermal results showed important physiological data related to vascularization of the bone fracture and areas adjacent to the trauma well correlated to radiographic examinations.

Keywords: Bone fracture; Bone lesion identification; Diagnostic tool; Emergence room; Infrared thermal imaging; Screening temperature.

Fig. 1

Sample size per body segment diagnosed with bone fracture

Fig. 2

Mean temperatures in tibial and fibular fractures and contralateral reference limb

Fig. 3

Fracture of the right tibia: a infrared image of the patient's lower limbs with the delimitation of the ROIs; b photograph for comparative analysis; c Radiographic image of the fracture

Fig. 4

Mean temperature in the ROIs corresponding to the fractures and contralateral in bones of the hand

Fig. 5

Left scaphoid bone fracture: a infrared thermogram of the volunteer's lower limbs with delimitation of the ROIs; b a photograph for comparative analysis; c corresponding radiography

Fig. 6

Mean temperature in fractures in the bones of the forearm and contralateral reference limb

Fig. 7

Proximal fracture of the right radius bone: a infrared image of the volunteer's upper limbs with the delimitation of the ROIs; b photograph for comparative analysis; c radiographic image for diagnostic correlation

Fig. 8

Mean temperatures in fractures of the clavicle bone and contralateral reference limb

Fig. 9

Right clavicle fracture: a infrared image of the volunteer's lower limbs with the delimitation of the ROIs; b photograph for comparative analysis; c radiographic image for diagnostic correlation

Fig. 10

Mean temperatures in foot fracture bone and contralateral reference limb

Fig. 11

Left foot phalange fracture: a infrared image of the patient's lower limbs with the delimitation of the ROIs; b photograph for comparative analysis; c diagnostic correlation radiographic image

Fig. 12

Mean temperatures in ankle fracture bone and contralateral reference limb

Fig. 13

Left malleolus fracture: a Infrared image of the patient's lower limbs with the delimitation of the ROIs; b photograph for comparative analysis; c diagnostic correlation radiographic image

Fig. 14

a Shows the thermal image of an acute fracture of the left hand (scaphoid bone) and contralateral limb, with the delimitation of (ROI) defined for comparative analysis; b visible image of the evaluated limb; c shows the radiographic image of the bone trauma