Infrared Thermal Imaging Maybe an Available Tool to Detect Arthrorrhagia in Patients with Hemophilia

Objective:

Infrared thermal imaging(IRTI) , a technique that can measure and visualize infrared radiation, has been used as a diagnostic and therapeutic aid for many years in various clinical settings including trauma, tumor and inflammation. Recently, IRTI was found

to show great advantages in patients with hemophilia. This study aimed to assess Infrared thermal imaging(IRTI) for detecting arthrorrhagia in patients with hemophilia.

Methods: Twenty-eight hemophiliac patients were included in this study. Joint bleedings were detected at varying degrees using IRTI as well as validated by ultrasonography.

Results: The median ages (IQR) were 7.7 (4.3) and 36.2 (34.8) years, respectively.

Fifteen hemophiliac patients with no joint bleeding were included, with a median age (IQR) of 15.2 (16.0) years. Using IRTI, mean temperature (T mean) and maximum temperature (T max) at skin surface in the region of interest (ROI) in the bleeding group were higher than in the non-bleeding group with P < 0.05.

When patients with arthrorrhagia were subgroup analyzed by disease severity based on physical examination, the moderate to severe bleeding had T mean and T max higher than the mild bleeding group with statistical significance. The heat distribution index (HDI), two standard deviations of all pixel temperature values in the ROI, in the moderate to severe bleeding group was higher than in the healthy controls (P= 0.029).

The receiver operating characteristic analysis in bleeding detection revealed diagnostic sensitivity of 85.8% and 71.4% and specificity of 80.0% and 93.3% at cut-off points of T mean ≥ 34.0 °C and T max ≥36.3 °C, respectively. For patients with hemophilia, Infrared Imaging Tools are useful in detecting arthrorrhagia , providing high sensitivity (89.3%) and specificity (84.3%).

Conclusions: Our study demonstrated that IRTI was an applicable tool for detecting arthrorrhagia in patients with hemophilia.