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Quantification of thermal asymmetry. Part 2: Application in low-back pain and sciatica
S Uematsu1, W R Jankel, D H Edwin
1Department of Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Journal of Neurosurgery
|October 1, 1988
Summary
Low-back pain patients show significant lower extremity temperature asymmetry, with the affected limb being cooler. Thermometric scanning effectively detects root impingement, aiding diagnosis and avoiding invasive procedures.
Area of Science:
- Neurology
- Diagnostic Imaging
Background:
- Low-back pain is a prevalent condition often associated with neurological deficits.
- Accurate diagnosis of the underlying cause, such as root impingement, is crucial for effective treatment.
- Current diagnostic methods can be invasive or have limitations, particularly in specific patient populations.
Observation:
- A computerized thermometric scanning system was used to measure temperature differences in the lower extremities of 144 low-back pain patients.
- Significant thermal asymmetries were observed, with the involved limb consistently cooler than the unaffected limb (p < 0.001).
- Comparison with 90 healthy controls established a baseline for normal temperature distribution.
Findings:
- When temperature asymmetry exceeded one standard deviation from control values, thermometry demonstrated a 94.7% positive predictive value for detecting root impingement.
- The specificity of thermometry in identifying root impingement was 87.5%.
- These findings highlight the efficacy of thermometric asymmetry calculation in diagnosing root impingement.
Implications:
- Thermometric scanning offers a non-invasive, highly effective method for evaluating low-back pain patients, particularly those with psychosocial factors where other tests may be less revealing.
- This diagnostic tool provides valuable information for clinical decision-making, potentially reducing the need for more invasive procedures like myelography or exploratory surgery.
- Thermometry can improve diagnostic accuracy and patient management in cases of suspected radiculopathy.