Infrared thermography as a screening method for detecting idiopathic scoliosis


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Abstract

Diagnosis and treatment of scoliosis are among the most urgent and important issues in the field of traumatology and orthopedics. Despite the large number of currently existing methods for diagnosing scoliosis, the search for new methods and the improvement of old ones continues to this day. Goal. Investigation of the possibility of using infrared thermography as a screening method for idiopathic scoliosis. Materials and methods. In the course of this study, using the resources of the electronic libraries Pub Med and Elibrary. A study was also conducted in which 56 people participated, of which 28 were female and 28 were male, aged from 18 to 23 years, height from 157 to 190 cm. Results. The indicators of temperature fluctuations in symmetrical areas of the back in groups of patients with each of their established degrees of severity of scoliosis were considered separately. For this, the indicators were evaluated from the points L1, R1; L2, R2; L3, R3; L4, R4 in each group, respectively. Conclusions. The reliability of thermography has been confirmed by many other authors, as well as by this study. According to the results of the indicators obtained during thermography, the presence of scoliosis in the subjects is confirmed (the average value in each of the symmetrical points is above 0.3 degrees).

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Introduction. Diagnosis and treatment of scoliosis are among the most urgent and important issues in the field of traumatology and orthopedics [1, 2]. Despite the large number of currently existing methods for diagnosing scoliosis, the search for new methods and the improvement of old ones continues to this day. X-ray, computed thermography, and magnetic resonance imaging are most often used for scoliosis screening, but radiation exposure to the human body is one of the serious disadvantages of these methods [3, 4].
Thermography is a new non–invasive, safe, non-contact diagnostic imaging method based on capturing infrared radiation emitted by the skin and creating images of temperature distribution, which may vary in certain areas of the body due to changes in blood supply and metabolic processes. Therefore, in the presence of pathology, the picture of temperature values will be different, which is a diagnostic sign [5, 6, 7].
Since scoliosis has a curvature of posture, deformity of the spinal column and the muscular system, temperature indicators in symmetrical areas are unequal, therefore thermal imaging is the most promising way to visualize and diagnose this orthopedic pathology [8, 9].
The aim of the work is to evaluate the possibilities of using infrared thermography as a screening method for idiopathic scoliosis.
Materials and methods of research. In the course of this study, using the resources of the electronic libraries Pub Med and Elibrary, the most relevant domestic and foreign literary sources over the past 5 years were analyzed, containing information and prospects of the thermographic method in the diagnosis of scoliosis.
A study was also conducted in which 56 people participated, of which 28 were female and 28 were male (significance level p=1.000) aged 18 to 23 years, height from 157 to 190 cm. Those taking drugs that disrupt bone metabolism, those suffering from hyperparathyroidism, those who have had fractures and surgeries in the last 5 months, and those who are obese were excluded from the study.
All participants were divided into 2 groups according to the severity of scoliosis, respectively: grade 1 scoliosis, grade 2 scoliosis, persons without scoliosis. Before conducting the study using a thermograph, the subjects underwent a preliminary examination, an Adams test to differentiate structural scoliosis from functional scoliosis. Next, all participants underwent thermography using a "Pergamed - 640" thermal imager. The temperature was assessed at 8 symmetrical points in the trapezius muscles (L1, R1), subclavian muscles (L2, R2), latissimus dorsi (L3, R3), and quadratus lumbar (L4, R4) in a specialized computer program, Rainbow mode.
The results of the study. In the study of Lyubkovskaya A. and co-authors (2020), the results of screening for idiopathic scoliosis in children and adolescents from 7 to 16 years old were presented [10]. The patients were divided into the main group, which included patients with scoliosis, and the control group, which consisted of healthy patients. The images were taken using the FLIR T1030sc HD thermal imaging camera. According to the results of the study, it was revealed that the temperature fluctuations between the upper and lower parts of the body were about 4 °C, while in healthy patients it did not exceed an average of 0.5 °C. The results of this study confirm the pattern of temperature fluctuations in symmetrical areas of the body in idiopathic scoliosis, which is detected using infrared thermography [10].
In this study, when assessing the degree of scoliosis in the respondents using a scoliometer, it was found that 98% of the participants had spinal deformity. In 34 subjects, the curvature of the angle of the scoliotic arch ranged from 7 to 14 °C (62%), in 21 participants – from 15 to 20°C (38%) (significance level p=0.014). According to the data obtained, the patients were divided into 2 groups corresponding to the severity of scoliosis (grade 1 and grade 2 scoliosis, respectively).
Later, a study was carried out using a thermal imager and an analysis of the results obtained.
The indicators of temperature fluctuations in symmetrical areas of the back in groups of patients with each of their established degrees of severity of scoliosis were considered separately. For this, the indicators were evaluated from the points L1, R1; L2, R2; L3, R3; L4, R4 in each group, respectively. When analyzing the data using the Excel spreadsheet, the following results were obtained: in patients in the group with grade 1 scoliosis, temperature fluctuations at points L1, R1 were 0.33 °C; L2, R2 – 0.33 °C; L3, R3 – 0.46 °C; L4,R4 – 0.45°C. While in patients with grade II scoliosis, the data were different: at points L1, R1 - 0.32 °C; L2, R2 – 0.44 °C; L3, R3 – 0.42 °C, L4, R4 – 0.31 °C.
Conclusions. Idiopathic scoliosis is a common problem among all segments of the population, especially adolescent children. Modern medicine has a large number of diagnostic methods for this disease, the "gold standard" of which is radiography. However, medical thermography, in comparison with this diagnostic method, has its own certain positive aspects, which is especially important to take into account: the absence of radiation exposure, accessibility, non-invasiveness, safety, and speed of implementation.
The reliability of this method has been confirmed by many other authors, as well as by the present study. According to the results of the indicators obtained during thermography, the presence of scoliosis in the subjects is confirmed (the average value in each of the symmetrical points is above 0.3 degrees). In addition, temperature parameters, the difference of which varies in different pathological areas, may indicate the localization of the process, which varies depending on the severity of the disease, which is confirmed by the data of the study. However, in order to confirm the high effectiveness and prospects of this diagnostic method, additional studies are needed, which may serve as a serious step towards the introduction of thermography as the main diagnostic method for scoliosis.

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About the authors

Victoria Olegovna Bogdanova

Tver State Medical University

Email: ammorozovv@gmail.com
ORCID iD: 0009-0007-8033-8202
SPIN-code: 1813-6287
Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

Sofia Dmitrievna Vasilyeva

Tver State Medical University

Email: ammorozovv@gmail.com
ORCID iD: 0009-0009-9307-9910
SPIN-code: 6829-4920
Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

Artem Mikhailovich Morozov

Tver State Medical University

Author for correspondence.
Email: ammorozovv@gmail.com
ORCID iD: 0000-0003-4213-5379
SPIN-code: 6815-9332

PhD., Associate Professor of the Department of General Surgery

Russian Federation, 170100, Russia, Tver, Sovetskaya str., 4

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