| BackgroundThe incidence of acute gouty arthritis(AGA)is gradually increasing with the improvement of people's standard of living.Intra-articular injection of triamcinolone acetonide can rapidly reduce inflammation and relieve pain in the AGA patients.However,assessment of the diseased joint could not dependent on the patient's subjective description.So,how to quickly and objectively discover the affected joints from images and improve the accuracy of treatment is a focus and hotspot of current studies.What's more,how to use imageological studies to evaluate the efficacy before and after treatment is also a difficult point in current research.Through clinical trials,this study employed infrared thermography to accurately and intuitively find the diseased joints,and the examination was performed again to make objective evaluation for pain relief after intra-articular injection of triamcinolone acetonide to relieve pain.At the same time,the levels of uric acid and high-sensitivity C-reactive protein(hs-CRP),and erythrocyte sedimentation rate were detected,and the correlation of these indexes with the severity of pain was analyzed in order to provide a basis for clinical treatment of gouty arthritis.MethodsGeneral patients with identified gouty arthritis admitted in our department were collected in the study.Infrared thermography,Visual analog scale(VAS),AIS,uric acid,and hs-CRP levels were detected and analyzed before treatment.Infrared thermography and Visual analog scale(VAS)were detected and analyzed after treatment.Results1.Infrared thermography showed the location of lesion and the severity of painIn this group of patients,infrared thermography before treatment found that the location of pain showed different color gradations.In comparison with the contralateral side and the joint of healthy individuals,it was found that the infrared thermography can accurately reflect the location and severity of pain.2.Infrared thermogram and temperature difference of diseased joints before and after treatment.Comparison of VAS scores before and after treatment.After the infrared thermograms of the diseased joint before and after treatment were analyzed and the difference between the temperatures on the affected side and on the healthy side was measured,the results showed that color gradation of the location of pain was changed and the severity of pain was also reduced.The temperature difference and the VAS scores were obvioudly decreased after the treatment(P<0.05).3.Comparative analysis of multiple factors between the severe and mild groupsCompared with the mild group,the severe group had obviously higher AIS score,significant difference between the temperature of the affected side and healthy side,and higher serum hs-CRP level(P<0.05).There were no significant differences in serum uric acid level and erythrocyte sedimentation rate between the two groups(P>0.05).Correlation analysis showed that VAS score was positively correlated with AIS score(r=0.465,P<0.001),difference of joint infrared thermal value(r=0.701,P<0.001),and serum hs-CRP level(r=0.869,P<0.001).The AIS score was positively correlated with hs-CRP level(r=0.404,P<0.001).The infrared thermal difference of the joint was positively correlated with the hs-CRP level(r=0.550,P<0.001).Conclusion1.Infrared thermography can accurately detect the location of pain,and play a good auxiliary role in the treatment of gouty arthritis by intra-articular injection.2.Infrared thermography can reflect the changes in pain severity before and after treatment,which is consistent with the change of painfulness in the AGA patients after injection of triamcinolone acetonide.Infrared thermography provides an objective and visual basis for the assessment of treatment effect.3.The more severe the pain in the AGA patients,the greater the difference in the temperature between the affected side and healthy side of joint,which is consistent with the serum hs-CRP level and pain severity. |
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