Localization Diagnosis Value Of Infrared Thermography For Pain Sites And Targeting Effect Of Adjuvant Therapy

Background:Pain,as a subjective feeling,is difficult to record the reaction accurately and objectively in clinical practice,either in the oral description of the patient himself or in the written expression of the manager.According to the current relevant studies,pain mainly includes the location of pain,the degree of pain,the nature of pain,the frequency of pain onset,the duration of pain,the aggravating or relieving factors of pain and the accompanying symptoms of pain^[1].At present,it is mainly expressed through various subjective rating scales,and its subjectivity and instability are not very reliable.Therefore,it is very important to describe the objective chemical tools of pain,and it is of great significance to describe pain objectively for clinical diagnosis and treatment.Medical infrared thermal imaging,by receiving the infrared energy radiation of human body oneself,clearly and accurately record the body temperature of each part on the image^[2],and its image in office a little or surface temperature measurement and post-processing,provide objective radiographic images,analyze and judge the human body can indirectly through professional related symptoms that may occur,so as to achieve the goal of clinical auxiliary diagnosis.By referring to relevant literature,infrared thermal imaging is currently mainly used for the diagnosis of neuro-related diseases,vascularized diseases,osteoarthropathy,myofastitis of pain syndromes,sports tissue injury,skin related diseases,breast cancer and other diseases^[3-4].In osteoarthritis,knee arthritis and spondylitis have been reported in many literatures,and no research reports on chronic ankle osteoarthritis have been found.No related studies on the treatment of chronic periarthritis of shoulder have been reported.In this study,medical infrared thermal imager was used to study the image characteristics of chronic ankle osteoarthritis and its combined shockwave treatment of chronic periarthritis of shoulder in a randomized controlled trial,and to explore the role of infrared thermal imaging in the location diagnosis of pain sites and the clinical value of possible assistance in improving the clinical treatment effect.Objectives:The infrared thermal imager was used to detect the temperature of chronic ankle osteoarthritis and healthy people in different parts.To compare the characteristics of infrared imaging of chronic ankle osteoarthritis;In addition,the temperature value of chronic periarthritis of shoulder at different parts was tested,and combined with the targeted treatment of shock wave.A randomized controlled clinical trial was conducted to further explore whether it can improve the clinical effect of chronic periarthritis of shoulder.Methods:1.Thirty-six standard cases of unilateral chronic ankle osteoarthritis were treated as an experimental group and 32 healthy people as a control group.The two groups of samples were tested on four different parts of the bilateral ankle joint?front,back,inside and outside?.The temperature data of the two groups in different areas of both ankles were measured by the rectangular area method.Statistical analysis was performed to compare the significant differences between the two groups in different locations.2.The randomized controlled trial design method was used to divide 78 patients with chronic periarthritis who met the standards into the experimental group?39 cases?and the control group?39 cases?by the random number table method.The experimental group is infrared thermal imaging diagnosis combined with shockwave therapy.The control group was treated by shock wave alone.Patients in the two groups were observed before and 1month,6 months and 12 months after treatment,and their pain degree?NRS?score,shoulder activity?ROM?score and daily life ability?ADL?score were observed.Results:1.Infrared thermal imaging for the detection of chronic ankle osteoarthritis:Group within the ankles temperature difference value,than that of front and outside ankle temperature decreased obviously?have significant difference,the front temperature difference value is.4 2?.16?,the outside temperature difference value is.3 9?.17??,the back and the inside ankle temperature slightly lower than that of ankle?there was no significant difference,the back temperature difference value is.1 6?.06?,the inside temperature difference value is.1 6?.06??,and the control group in ankles temperature difference value of front,back,inside and outside is11.?.0 6??.1 2?5.0??.0 9?.0 4??.0 9?.05?,there was no significant difference;There were significant differences in the temperature difference between the anterior and lateral groups,but no significant differences between the posterior and medial groups.2.The role of infrared thermal imaging in pain localization diagnosis:Through the above study found,infrared thermal imaging of superficial tissue?joints,etc.?of different parts of the concrete temperature changes are pointing to the role,can use the technique in the treatment before and testing,to guide the clinical treatment of positioning,to avoid the site of disease?inflammation,etc.?to unnecessary treatment,which may avoid the iatrogenic injury.3.Clinical randomized controlled trial of far-infrared thermal imaging combined with shock wave in the treatment of chronic periarthritis of shoulder:Two groups of NRS pain score after treatment 1 month?P?28?0.018?27?0.05?,6 months?P?28?0.021?27?0.05?and12 months?P?28?0.037?27?0.05?,there are significant differences,pain NRS score significantly decreased after treatment,the movement Angle of shoulder joint forward flexion,back extension and outspread obviously increased,and there were significant differences in ADL scores at 1 month?P?28?0.024?27?0.05?,6 months?P?28?0.021?27?0.05?and12 months?P?28?0.023?27?0.05?after treatment.After treatment,ADL scores reached above90 points,and the independent living ability was basically restored.Conclusion:Chronic ankle osteoarthritis detected by infrared thermal imaging showed significant difference only in the anterior and lateral parts of the ankle joint.In addition,infrared thermal imaging combined with shockwave in the treatment of chronic scapulohumeral periarthritis is better than the pure shockwave treatment.In summary,infrared thermal imaging has the value of locating and diagnosing the pain area of superficial tissues?joints,etc.?.By taking advantage of this characteristic,it has a directional effect on the clinical treatment area.Combined with shock wave therapy,it can improve the clinical efficacy of chronic periarthritis of shoulder.