Thermal Imaging Today and Its Relevance to Diabetes
Figure 4: Palmar view of hand showing cold fourth and fifth fingers.
become hotter for a time than the rest of the
hand. A delayed and protracted recovery,
leaving fingers colder than before immersion,
may be typical of Raynaud’s phenomenon
and may be a feature of another condition
such as rheumatoid arthritis or diabetes
mellitus (Figure 4). An advantage of thermal
imaging is that this test can be graded for
severity by quantification, and the effects of
any prescribed medication to improve the
symptoms can be measured.
Brånemark and colleagues (11) noted
characteristic abnor-malities in the
thermal patterns over the hands and feet
of 16 diabetes patients with and without
vascular complications. They concluded that
thermography was a useful technique for
the study of circulation and metabolism in
diabetes. Cold stimulation was used by Jiang
and associates (12) in 2003 to assess metabolic
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status in diabetes, which they considered to be
highly specific. In another study of 60 patients,
Marcinkowska-Gapińska and Kowal (13)
analyzed the rheological parameters of blood
in 18 diabetes patients and compared them
with a group of 20 postmyocardial infarction
patients, the remainder being healthy controls.
They compared the results with the skin
temperature data obtained by thermography.
Using a cold stress at 20 ºC, a Japanese study
found a high correlation between the thermal
recovery measured by thermography and laser
Doppler flowmetry at the feet. (14)
From these studies, the different authors all
found that infrared thermography was a valid
measure of skin temperature that directly
related to peripheral circulation, especially
after the application of a mild cold stress to
the extremities.