European Journal of Pediatrics

, Volume 174, Issue 4, pp 493–499 | Cite as

Infrared thermography is useful for ruling out fractures in paediatric emergencies

  • Enrique Sanchis-Sánchez
  • Rosario Salvador-PalmerEmail author
  • Pilar Codoñer-Franch
  • José Martín
  • Carlos Vergara-Hernández
  • José Blasco
  • Esther Ballester
  • Enrique Sanchis
  • Rolando González-Peña
  • Rosa Cibrián
Original Article


Musculoskeletal injuries are a leading cause of paediatric injuries and emergency department visits in Western countries. Diagnosis usually involves radiography, but this exposes children without fractures to unnecessary ionising radiation. We explored whether infrared thermography could provide a viable alternative in trauma cases. We compared radiography and thermal images of 133 children who had been diagnosed with a trauma injury in the emergency unit of a Spanish hospital. As well as the thermal variables in the literature, we introduced a new quantifier variable, the size of the lesion. Decision tree models were built to assess the technique’s accuracy in diagnosing whether a bone had been fractured or not. Infrared thermography had a sensitivity of 0.91, a specificity of 0.88 and a negative predictive value of 0.95. The new lesion size variable introduced appeared to be of main importance to the discriminatory power of the method.

Conclusion: The high negative predictive value of infrared thermography suggests that it is a promising method for ruling out fractures.


Fractures Infrared thermography Ionising radiation Musculoskeletal injuries Paediatric injuries 



Differences of maximum temperatures


Differences of average temperatures


Differences of areas


Area under the curve


Classification and regression trees


Diagnostic odds ratio


Confidence interval


Negative likelihood ratio


Negative predictive value


Positive likelihood ratio


Positive predictive value


Region of interest


Standard deviation





Supplementary material

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ESM 1 (TIFF 3201 kb)
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High Resolution Image (GIF 244 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Enrique Sanchis-Sánchez
    • 1
  • Rosario Salvador-Palmer
    • 2
    Email author
  • Pilar Codoñer-Franch
    • 3
    • 4
  • José Martín
    • 5
  • Carlos Vergara-Hernández
    • 5
  • José Blasco
    • 1
  • Esther Ballester
    • 3
  • Enrique Sanchis
    • 5
  • Rolando González-Peña
    • 2
  • Rosa Cibrián
    • 2
  1. 1.Department of Physical TherapyUniversitat de ValènciaValenciaSpain
  2. 2.Department of PhysiologyUniversitat de ValènciaValenciaSpain
  3. 3.Department of PediatricsUniversity Hospital “Dr. Peset”ValenciaSpain
  4. 4.Department of Pediatrics, Obstetrics and GynecologyUniversitat de ValènciaValenciaSpain
  5. 5.Department of Electronic EngineeringUniversitat de ValènciaValenciaSpain

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