Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2016; 26(06): 288-292
DOI: 10.1055/s-0042-115478
Wissenschaft und Forschung
© Georg Thieme Verlag KG Stuttgart · New York

Infrared Thermographic Pattern of Lower Limb Complex Regional Pain Syndrome (Type I) and its Correlation with Pain, Disease Duration and Clinical Signs

Das infrarot-thermografische Muster beim Komplexen Regionalen Schmerzsyndrom Typ I der unteren Extremität und Korrelation mit Schmerz, Krankheitsdauer und Symptomen
O. Schuhfried
1   Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
,
M. Herceg
1   Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
,
G. Reichel-Vacariu
2   Institute of Physical Medicine and Rehabilitation, Orthopedic Hospital Speising, Vienna, Austria
,
T. Paternostro-Sluga
3   Institute of Physical Medicine and Rehabilitation, Danube Hospital – Sozialmedizinisches Zentrum Ost, Vienna, Austria
› Author Affiliations
Further Information

Publication History

received: 29 March 2016

accepted: 16 August 2016

Publication Date:
12 December 2016 (online)

Abstract

Purpose: So far, the use of infrared-thermography in the diagnosis of the Complex Regional Pain Syndrome (CRPS) has been described only for the upper extremity or jointly for the upper and lower extremity. Therefore, the aim of this study was the assessment of the absolute temperature side-to-side difference by infrared thermography in patients with CRPS Type I of the lower limb. It was investigated whether there are correlations between the amount of temperature side-to-side difference, pain, duration of the disease and clinical signs.

Materials and Methods: 25 women and 11 men (mean age 48 years), who fulfilled the Budapest clinical criteria of CRPS type I, were investigated in this retrospective cross-sectional study. Infrared thermographic evaluation of the big toe, dorsal foot, ankle and distal anterior lower thigh was performed. The arithmetical mean of the absolute side-to-side differences of these 4 regions of interest was calculated=average side-to-side temperature difference of the distal lower limb. The correlation of the average side-to-side temperature difference of the distal lower limb with pain, duration of the disease and clinical signs (sensory, vasomotor, sudomotor/edema and motor/trophic) was assessed.

Results: The average absolute side-to-side temperature difference of the distal lower limb was 1.6/1.2°C (mean/SD). A significant correlation between the temperature asymmetry was observed with the vasomotor signs.

Conclusions: Infrared thermography offers an objective assessment of vasomotoric dysfunction in CRPS type I of the lower limb, and therefore serves as a useful supplementary tool in the diagnosis of CRPS type I.

Zusammenfassung

Fragestellung: Bisher wurde der Einsatz der Infrarot-Thermografie in der Diagnose des Komplexen Regionalen Schmerzsyndroms (CRPS) nur für die obere Extremität oder gemeinsam für die obere und untere Extremität beschrieben. Das Ziel dieser Studie war daher die Erhebung der absoluten Temperaturseitendifferenz bei Patienten mit CRPS Typ I der unteren Extremität. Es wurde untersucht, ob es Korrelationen zwischen der Ausprägung der Temperaturseitendifferenz, Schmerzen, Erkrankungsdauer und Symptomen gibt.

Material und Methoden: 25 Frauen und 11 Männer (mittleres Alter 48 Jahre), die die klinischen Budapest Kriterien eines CRPS Typ I erfüllten, wurden in dieser retrospektiven Querschnittsstudie untersucht. Die infrarot-thermografische Untersuchung der großen Zehe, des Fußrückens, Knöchels und des distalen Unterschenkel wurde durchgeführt. Das arithmetische Mittel der absoluten Seitendifferenz dieser vier Regionen wurde berechnet=durchschnittliche Temperaturseitendifferenz der distalen unteren Extremitäten. Die Korrelation der durchschnittliche Temperaturseitendifferenz der distalen unteren Extremitäten mit Schmerzen, Dauer der Erkrankung und den klinischen Symptomen (sensorische, vasomotorische, sudomotorisch/ödematöse und motorisch/trophische) wurde erhoben.

Ergebnisse: Die durchschnittliche Temperaturseitendifferenz der distalen unteren Extremitäten war 1,6/1,2°C (Mittelwert/SD). Eine signifikante Korrelation zwischen der Temperaturasymmetrie mit den vasomotorischen Symptomen wurde beobachtet.

Schlussfolgerungen: Die Infrarot-Thermografie bietet eine objektive Beurteilung der vasomotorischen Dysfunktion bei CRPS Typ I der unteren Extremität und dient somit als nützliches zusätzliches Instrument in der Diagnose des CRPS Typ I.

 
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