Infrared thermal imaging analysis in screening for toddler’s fracture: A proof-of-concept study

This study explored and developed high-resolution infrared thermal (HRIT) imaging for screening toddler’s fractures. A toddler’s fracture is a common tibial fracture in children younger than six years old. The study included 39 participants admitted to an emergency department with a suspected toddler’s fracture. X-ray confirmed eight participants with a toddler’s fracture (20.5%). Infrared images of participants were recorded on their index visit, focusing on region-of-interests on the injured and the contralateral (uninjured) legs. The uninjured leg acted as a thermal reference. Six statistical measures obtained from the images were analyzed. These were maximum, mean, standard deviation, median, interquartile range, and skewness. The Shapiro–Wilk test indicated that the measures were from a normal distribution. A two-sample t-test indicated that the majority of the six measures had significantly different means (p < 0.05) when comparing the participants with and without a fracture. Similarly, the first principal component (PC1), obtained through principal component analysis of the six measures, was significantly different (p < 0.05) comparing participants with and without a fracture. Visualization of the statistical measures and their PC1 demonstrated distinct clustering. This study demonstrated that HRIT imaging is valuable for screening for toddler’s fractures, but a larger follow-on study will be required to confirm the findings.