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- Title
The Role of Infrared Thermal Imaging and Sonography in the Assessment of Patients With A Painful Elbow.
- Authors
J., Gabrhel; Z., Popracová; H., Tauchmannová; K., Ammer
- Abstract
BACKGROUND: The human elbow is the compound of 3 articulations: the humeroradial, the proximal radioulnar and the humeroulnar articulation. The joint capsule has recesses and synovial folds, and is reinforced by ligaments. Fourteen bursae have been described in the elbow region, and seventeen muscles are crossing the elbow joint. All these structures are potential sources of pain. The most common causes of elbow pain include medial and lateral epicondylitis. AIMOFTHESTUDY: To investigate the value of infrared thermography and sonography for the differential diagnosis of elbow pain and to define the prevalence of causes of elbow pain in a group of patients referred for treatment to a private practice of rehabilitation medicine. METHOD: Retrospective chart review was conducted of patients with a painful elbow who were referred for treatment between January 2013 and December 2015, and underwent a complete clinical, musculoskeletal, thermographic and sonographic examination. RESULTS: In total 43 patients underwent a complete examination, 35 subjects of them had problems on one side only. 5 exhibited pain on both arms, either on the medial or lateral site and 3 patients had symptoms at the medial and lateral site of both elbows. Any painful finding on the elbow was defined as case, and the 43 subjects comprised in total 57 cases. The following clinical diagnosis were made: 21 cases with lateral epicondylitis, 13 cases with medial epicondylitis, 4 cases with bursitis, 14 cases with sequelae of injuries and 5 unclear cases. Thermal imaging detected 51 cases with increased temperature, 4 cases with decreased temperature and 5 cases exhibited normal temperatures. 45 sonographic examinations were positive and 12 were negative. Diagnostic sensitivity of thermal imaging for clinical diagnosis was 91%. The rate of true positive sonograms for clinical diagnosis was 71%. CONCLUSION: Epicondylitis is considered as the primary cause of elbow pain. In private practice of rehabilitation medicine, however, they only represent slightly more than 50% of all the cases. Slightly less than half of all elbow pain show very different causes and their exact specification is difficult without the use of imaging techniques. Infrared imaging is highly sensitive in the case of epicondylitis, and can supplement morphology based imaging with information on the acuteness of morphological changes.
- Subjects
ELBOW pain; MEDICAL thermography; ULTRASONIC imaging; MEDICAL rehabilitation; INFRARED thermometers; DIAGNOSIS
- Publication
Thermology International, 2017, Vol 27, Issue 2, p58
- ISSN
1560-604X
- Publication type
Article