Utility of a Smart Device Infrared Camera in Localizing Acute Pediatric Long Bone Fractures: A Pilot Study.
Journal
Pediatric emergency care
ISSN: 1535-1815
Titre abrégé: Pediatr Emerg Care
Pays: United States
ID NLM: 8507560
Informations de publication
Date de publication:
14 Oct 2024
14 Oct 2024
Historique:
medline:
14
10
2024
pubmed:
14
10
2024
entrez:
14
10
2024
Statut:
aheadofprint
Résumé
Musculoskeletal injuries are one of the top 10 reasons children present to the emergency department (ED). Infrared thermal imaging (IRT) is a noninvasive and nonradiating imaging modality that can detect subtle temperature differences. IRT may be used to detect the presence of musculoskeletal injury. This study aimed to assess the utility of a smart device infrared camera attachment's ability to localize acute pediatric long bone fractures in patients less than 5 years of age. This was a prospective pilot study comparing thermal imagery on an injured extremity to radiographs. All IRT images were obtained via an iPad with an infrared camera attachment. Using two different IRT images (Hi/Lo and Span and Level), the area of maximum temperature (Tmax) was identified and compared to radiographs. A total of 31 patients were enrolled in the study. Twenty-four (77.50%) were identified as having fractures, and 7 (22.50%) did not have any fractures. IRT correctly identified an injury in the fracture group 91.67% of the time when using the Span and Level IRT image compared to standard x-rays (P < 0.0002). When using the Span and Level image to identify Tmax to localize a fracture on x-ray, sensitivity is 0.92, specificity is 0.86, positive predictive value is 0.96, and negative predictive value is 0.75. A receiver operating characteristic (ROC) curve was completed with area under the curve (AUC) being 0.89. This pilot study shows that the use of smart device infrared camera attachments is feasible and has promising results in fracture localization. This could allow for a decrease in radiographs and be particularly useful in resource-limited areas.
Sections du résumé
BACKGROUND
BACKGROUND
Musculoskeletal injuries are one of the top 10 reasons children present to the emergency department (ED). Infrared thermal imaging (IRT) is a noninvasive and nonradiating imaging modality that can detect subtle temperature differences. IRT may be used to detect the presence of musculoskeletal injury.
OBJECTIVE
OBJECTIVE
This study aimed to assess the utility of a smart device infrared camera attachment's ability to localize acute pediatric long bone fractures in patients less than 5 years of age.
METHODS
METHODS
This was a prospective pilot study comparing thermal imagery on an injured extremity to radiographs. All IRT images were obtained via an iPad with an infrared camera attachment. Using two different IRT images (Hi/Lo and Span and Level), the area of maximum temperature (Tmax) was identified and compared to radiographs.
RESULTS
RESULTS
A total of 31 patients were enrolled in the study. Twenty-four (77.50%) were identified as having fractures, and 7 (22.50%) did not have any fractures. IRT correctly identified an injury in the fracture group 91.67% of the time when using the Span and Level IRT image compared to standard x-rays (P < 0.0002). When using the Span and Level image to identify Tmax to localize a fracture on x-ray, sensitivity is 0.92, specificity is 0.86, positive predictive value is 0.96, and negative predictive value is 0.75. A receiver operating characteristic (ROC) curve was completed with area under the curve (AUC) being 0.89.
CONCLUSIONS
CONCLUSIONS
This pilot study shows that the use of smart device infrared camera attachments is feasible and has promising results in fracture localization. This could allow for a decrease in radiographs and be particularly useful in resource-limited areas.
Identifiants
pubmed: 39400291
doi: 10.1097/PEC.0000000000003278
pii: 00006565-990000000-00534
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: The authors declare no conflict of interest.
Références
Alison M, Azoulay R, Tilea B, et al. Imaging strategies in paediatric musculoskeletal trauma. Pediatr Radiol. 2009;39(Suppl 3):414–421.
McDermott K, Stocks C, Freeman W. Overview of Pediatric Emergency Department Visits, 2015: Statistical Brief# 242. 2018.
Cohen LL, Lemanek K, Blount RL, et al. Evidence-based assessment of pediatric pain. J Pediatr Psychol. 2008;33:939–955; discussion 956-7.
Tomlinson D, von Baeyer CL, Stinson JN, et al. A systematic review of faces scales for the self-report of pain intensity in children. Pediatrics. 2010;126:e1168–e1198.
Myers MT, Thompson GH. Imaging the child with a limp. Pediatr Clin North Am. 1997;44:637–658.
Chojnowski M. Infrared thermal imaging in connective tissue diseases. Reumatologia. 2017;55:38–43.
Lin PH, Saines M. Assessment of lower extremity ischemia using smartphone thermographic imaging. J Vasc Surg Cases Innov Tech. 2017;3:205–208.
Ring EF, Ammer K. Infrared thermal imaging in medicine. Physiol Meas. 2012;33:R33–R46.
Saxena AK, Willital GH. Infrared thermography: experience from a decade of pediatric imaging. Eur J Pediatr. 2008;167:757–764.
Sanchis-Sánchez E, Salvador-Palmer R, Codoñer-Franch P, et al. Infrared thermography is useful for ruling out fractures in paediatric emergencies. Eur J Pediatr. 2015;174:493–499.
Silva CT, Naveed N, Bokhari S, et al. Early assessment of the efficacy of digital infrared thermal imaging in pediatric extremity trauma. Emerg Radiol. 2012;19:203–209.
Affshana MM, Priya J. Healing mechanism in bone fracture. J Pharm Sci Res. 2015;7:441.