In contrast with MRI scanning, thermography is more accessible. In common with MRI, thermography is a totally non-invasive method of investigating the cause of chronic pain.
Thermography is used to assess many conditions, in particular, breast cancer, disorders of the blood vessels in the limbs, skin diseases, and disorders of the testicles.
It has been used extensively overseas in sports medicine, particularly in the early diagnosis of stress fractures. It has also been used in the diagnosis and management of arthritis and of chronic or recurrent headaches, particularly cluster headaches.
The entire process only takes an hour and involves the patient sitting for 15 minutes until the body temperature stabilises. Then, three sets of pictures are taken at fifteen minute intervals, again for the body to settle down.
Thirty to 50 images are collected on to the infra-red equipment linked to a computer. They are stored on a floppy disc and then replayed on a high resolution TV monitor.
They can be studied and photographed with a single-lens reflex camera. A series of colour transparencies is produced. These are studied using a light box and a magnifying glass.
Pictures true to the original transparencies can be produced on instant film for the referring physician.
Chronic pain of any origin appears to cause cooling in the adjacent skin and the picture of the body that thermography gives shows the temperature of the different areas of the skin. Certain diseases, injuries and chronic pain cause changes in skin temperature. Also:
• Inflammation causes increased heat.
• Muscle spasm causes increased heat.
• Cutting a peripheral nerve (the final nerve pathway) causes increased heat in the skin supplied for up to five months. This is followed by cooling in the area.
• Nerve root irritation usually causes cooling in the appropriate area of skin supplied by the affected specific nerves.
Thermography is gaining increasing acceptance and is a highly effective, alternative way to diagnose the increasing number of soft tissue injuries.
Because the assessment is photographically reproducible, it adds an extra dimension to the doctor’s ability to diagnose or establish that there is, or is not, a basis for the pain. While the principles of thermography have been available for some time, it is only recently that the teaming of computer technology with infra-red imaging techniques has made modern thermography possible.
Thermography is a totally safe investigation because no radiation is involved in the process. There are no side-effects whatever and the only inconvenience is the need to remove clothing from the affected area. For example, if the painful area is in the upper part of the body, the patient has to strip off to the waist. This is necessary because the thermogram is so accurate that even the smallest garment will show up.
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