Doctors Hooshmand, Hashmi and I have co-authored the following article: Infrared Thermal Imaging As A Tool In Pain Management – An 11 Year Study, Part I of II.
This original article is part one of a two part article of an 11 year study of Infrared Thermal Imaging As A Tool In Pain Management.
Below is an abstract from the article Infrared Thermal Imaging As A Tool In Pain Management - An 11 Year Study, Part I of II.
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Thermography Article Part I
Infrared Thermal Imaging As A Tool In Pain Management –
An 11 Year Study, Part I of II
Hooshang Hooshmand, Masood Hashmi, Eric M. Phillips
Neurological Associates Pain Management Center
Vero Beach, Florida, USA.
The value of Infrared thermal imaging (ITI) is limited to evaluation of neurovascular dysfunction. It provides indispensable information regarding neuropathic pain due to perivascular microcirculatory sympathetic dysfunction. ITI records superficial, and deep temperature changes. The bilateral cervical cord temperature modulation demands careful clinical correlation. The ITI is an objective guide helping the clinician to choose a proper and harmless treatment protocol, especially avoiding unnecessary surgery.
The anatomical tests such as magnetic resonance imaging (MRI), computed tomography (CT), and physiological tests such as electromyography (EMG) and nerve conduction velocity (NCV) tests have been the main diagnostic tools applied in the management of somesthetic (somatic) pain. The above tests usually are not informative in the diagnosis of neuropathic pain. The neurovascular involvement in neuropathic pain requires tests such as Infrared thermal imaging (ITI) and Quantitative sudomotor axon reflex test (QSART) that address autonomic (e.g., thermal) changes for a more accurate diagnosis and treatment. This is a study of the role of ITI in the diagnosis and management of pain. The results were compared with the information in medical literature.
Bales Scientific Thermal Processor and Agema Cameras were used for this study of 3,265 successive patients. A review of our experience with Infrared thermal imaging (ITI) and its role in pain management was conducted, and compared with the recent medical literature. The study was limited to the role of ITI in the management of complex chronic pain.
Sloppy technique, and poor background in basic neurophysiologic training, have contributed to poor utilization and interpretation of ITI. For the ITI to be accurate and clinically useful, proper technique, standardization, and proper clinical correlation are the minimal requirements. The basic physiology of autonomic thermoregulation is outlined in detail to help the clinician to properly understand and interpret the test. The dysfunction of thermal sensory nerves in the wall of arterioles cannot be detected by EMG or NCV and excluding the ITI test may mislead the clinician to diagnose the condition as "psychogenic" or "functional." Our results were compatible with the review of current medical literature.
ITI provides useful clinical information when applied with proper technique. It provides diagnostic and therapeutic information limited to diseases involving autonomic, neurovascular, and neuroinflammatory changes. Conversely, it cannot be expected to help diagnose nerve injuries with no microvascular involvement such as somesthetic nerve injuries. Proper teaching and understanding of thermoregulation helps the clinician to obtain indispensable information from this test.
Key Words - CRPS, Headache, Sympathectomy ,Thermography.
H.Hooshmand, M.Hashmi, E.M. Phillips. Infrared Thermal Imaging As A Tool In Pain Management - An 11 Year Study, Part I of II. Thermology international 11 / 2 (2001)