Developing and Piloting a Standardized Thermography Protocol to Expedite Rheumatology Referrals for Possible...

Area of Science:

• Rheumatology
• Medical Imaging
• Diagnostic Tools

Background:

• Inflammatory arthritis, such as rheumatoid arthritis (RA), causes significant morbidity and increased healthcare costs.
• Timely diagnosis and treatment are crucial but hindered by limited access to rheumatologists.
• Effective triage of rheumatology referrals based on symptom severity is essential.

Purpose of the Study:

• To develop and implement an infrared thermography (IRT) protocol as a screening tool in primary care.
• To assess IRT's ability to detect joint inflammation for rheumatology referral triage.

Main Methods:

• Participants with RA, osteoarthritis (OA), and controls underwent joint power Doppler ultrasound (PDUS) and IRT.
• IRT image analysis determined surface joint temperatures, with cutoff points established using PDUS as the gold standard.
• Patients with hand or foot joint pain were referred to rheumatology if they exceeded IRT cutoff points for inflammation.

Main Results:

• IRT measurements demonstrated robust interrater reliability.
• Established cutoff points for metacarpophalangeal and wrist joints effectively discriminated between inflamed and non-inflamed joints.
• In a pilot study, 50% of participants were referred to rheumatology based on IRT findings, with 80% seen within 4 weeks.

Conclusions:

• Infrared thermography shows promise as a reliable method for identifying joint inflammation.
• IRT offers a feasible approach to identify patients with thermal abnormalities for expedited rheumatologic evaluation.
• Further research is needed to refine IRT-based referral protocols for optimal utilization.