Does thermal imaging correlate with musculoskeletal examination in the identification of inflamed joints in children and young people with juvenile idiopathic arthritis? A prospective diagnostic accuracy study

WARD, Oliver, NWAIZU, Harriet, SAATCHI, Reza, RAMLAKHAN, Shammi and HAWLEY, Daniel (2018). Does thermal imaging correlate with musculoskeletal examination in the identification of inflamed joints in children and young people with juvenile idiopathic arthritis? A prospective diagnostic accuracy study. Rheumatology, 57 (supp 8).

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Abstract

Background: Evidence demonstrates early, aggressive treatment improves outcomes in juvenile idiopathic arthritis (JIA). Early diagnosis of joint inflammation rests largely on expert clinical examination, supported by radiological investigations. Thermal imaging (TI) is easily accessible and is useful in detecting joint inflammation in adult rheumatoid arthritis. This pilot study aimed to assess if high-resolution TI correlates with musculoskeletal examination in identification of changes in skin temperature and joint inflammation. Methods: Participants aged 4-16 years with a diagnosis of JIA and suspected knee joint inflammation (uni- or bilateral) were included. Exclusion criteria comprised presence of other conditions such as infection, which could confound the skin temperature signal. Participants were permitted to continue with their prescribed medicines. TI data and musculoskeletal examination findings were recorded on the same occasion (within a one hour time period) for both knee joints, prior to the participant receiving intra-articular steroid injections as part of their routine care. Participants acclimatised to room temperature for 10 minutes whilst sitting, ensuring no contact over the knees. TI data of the front and back of both knees was subsequently obtained in standing. A member of the clinical team then performed a detailed examination of knee joints documenting presence/absence of warmth, swelling and restriction. The research and clinical teams were blinded to suspicion. This study received full ethical approval, and all participants gave their written informed assent or consent before taking part. Results: Eleven participants were included (Mage = 10.6 years, range 5-15 years; 6 females). Correlation between TI (front and back) and musculoskeletal examination data was seen in participants 3, 5 and 10. Partial correlation between TI (front or back) and musculoskeletal examination was seen in participants 1, 4, 9 and 11. Participant 8 had a fixed flexion knee deformity and abnormal gait pattern; TI and musculoskeletal examination data did not correlate for this individual. Conclusion: We describe novel data comparing musculoskeletal examination alongside TI recordings. Skin temperature did not always correlate with examination findings in this small cohort and we plan to compare TI with established imaging techniques (contrast-enhanced MRI and ultrasound) in clinically active JIA to explore this further.

Item Type:	Article
Additional Information:	** From Crossref via Jisc Publications Router **Journal IDs: pissn 1462-0324; eissn 1462-0332
Uncontrolled Keywords:	Pharmacology (medical), Rheumatology
Research Institute, Centre or Group - Does NOT include content added after October 2018:	Materials and Engineering Research Institute > Modelling Research Centre > Microsystems and Machine Vision Laboratory
Departments - Does NOT include content added after October 2018:	Faculty of Science, Technology and Arts > Department of Engineering and Mathematics
Identification Number:	https://doi.org/10.1093/rheumatology/key273.038
SWORD Depositor:	Margaret Boot
Depositing User:	Margaret Boot
Date Deposited:	31 Oct 2018 12:30
Last Modified:	18 Mar 2021 08:19
URI:	https://shura.shu.ac.uk/id/eprint/22990

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