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      Digital Thermography of the Fingers and Toes in Raynaud's Phenomenon

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          Abstract

          The aim of this study was to determine whether skin temperature measurement by digital thermography on hands and feet is useful for diagnosis of Raynaud's phenomenon (RP). Fifty-seven patients with RP (primary RP, n = 33; secondary RP, n = 24) and 146 healthy volunteers were recruited. After acclimation to room temperature for 30 min, thermal imaging of palmar aspect of hands and dorsal aspect of feet were taken. Temperature differences between palm (center) and the coolest finger and temperature differences between foot dorsum (center) and first toe significantly differed between patients and controls. The area under curve analysis showed that temperature difference of the coolest finger (cutoff value: 2.2℃) differentiated RP patients from controls (sensitivity/specificity: 67/60%, respectively). Temperature differences of first toe (cutoff value: 3.11℃) also discriminated RP patients (sensitivity/specificity: about 73/66%, respectively). A combination of thermographic assessment of the coolest finger and first toe was highly effective in men (sensitivity/specificity : about 88/60%, respectively) while thermographic assessment of first toe was solely sufficient for women (sensitivity/specificity: about 74/68%, respectively). Thermographic assessment of the coolest finger and first toe is useful for diagnosing RP. In women, thermography of first toe is highly recommended.

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          A reappraisal of the use of infrared thermal image analysis in medicine.

          B.F. Jones (1998)
          Infrared thermal imaging of the skin has been used for several decades to monitor the temperature distribution of human skin. Abnormalities such as malignancies, inflammation, and infection cause localized increases in temperature which show as hot spots or as asymmetrical patterns in an infrared thermogram. Even though it is nonspecific, infrared thermology is a powerful detector of problems that affect a patient's physiology. While the use of infrared imaging is increasing in many industrial and security applications, it has declined in medicine probably because of the continued reliance on first generation cameras. The transfer of military technology for medical use has prompted this reappraisal of infrared thermology in medicine. Digital infrared cameras have much improved spatial and thermal resolutions, and libraries of image processing routines are available to analyze images captured both statically and dynamically. If thermographs are captured under controlled conditions, they may be interpreted readily to diagnose certain conditions and to monitor the reaction of a patient's physiology to thermal and other stresses. Some of the major areas where infrared thermography is being used successfully are neurology, vascular disorders, rheumatic diseases, tissue viability, oncology (especially breast cancer), dermatological disorders, neonatal, ophthalmology, and surgery.
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            The design and analysis of clinical experiments

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              Raynaud's phenomenon.

              Raynaud's phenomenon is characterised by episodic vasospasm of the fingers and toes typically precipitated by exposure to cold. Mild Raynaud's is common and is not usually a harbinger of clinically important disability; its onset, however, can be startling and uncomfortable for patients, and the well recognised association in some cases with systemic rheumatic conditions often precipitates aggressive assessments for underlying diseases. Advances in vascular physiology have shed light on the role of the endothelium as well as endothelium-independent mechanisms in the altered vasoregulation of Raynaud's. We review clinical aspects of the disorder and new insights with respect to pathophysiology, and we discuss potential new therapeutics based on the disease mechanism, such as prostacyclin analogues, serotonin antagonists, and calcitonin gene-related peptides.
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                Author and article information

                Journal
                J Korean Med Sci
                J. Korean Med. Sci
                JKMS
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                1011-8934
                1598-6357
                April 2014
                01 April 2014
                : 29
                : 4
                : 502-506
                Affiliations
                [1 ]Division of Rheumatology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.
                [2 ]Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Korea.
                Author notes
                Address for Correspondence: Won Park, MD. Division of Rheumatology, Department of Internal Medicine, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea. Tel: +82.32-890-3483, Fax: +82.32-882-6578, parkwon@ 123456inha.ac.kr
                Author information
                http://orcid.org/0000-0002-7405-8139
                http://orcid.org/0000-0003-1262-2790
                http://orcid.org/0000-0002-5757-5775
                http://orcid.org/0000-0002-3517-5033
                http://orcid.org/0000-0002-1544-4486
                http://orcid.org/0000-0002-0004-8034
                Article
                10.3346/jkms.2014.29.4.502
                3991792
                24753696
                31d8f8b3-ded6-4da3-8415-ee0ac9907554
                © 2014 The Korean Academy of Medical Sciences.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 December 2013
                : 14 February 2014
                Funding
                Funded by: Inha University Research Grant
                Award ID: 44131-01
                Categories
                Original Article
                Immunology, Allergic Disorders & Rheumatology

                Medicine
                raynaud disease,thermography,digital thermography,temperature
                Medicine
                raynaud disease, thermography, digital thermography, temperature

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