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Infrared thermal imaging as a screening tool for paediatric wrist fractures

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Abstract

Wrist injuries are common in paediatric trauma; however, only half of children evaluated with an x-ray for possible fractures will have one. Thermal imaging offers a possible non-ionising method of screening for fractures and thus reducing negative x-ray rates. One hundred five children attending the Emergency Department for wrist injuries were recruited. Two 30-s thermal videos were recorded from injured and uninjured wrists—in flat and 45° elevated positions. A region of interest (ROI) was defined on each wrist. Cases in which the ROI was covered or had ice applied were excluded, leaving 40 patients for analysis. Comparisons of ROI included (i) injured and uninjured wrists—flat and elevated positions; (ii) as in (i) with a reference region on the proximal forearm subtracted; (iii) injured wrist ROI—flat and elevated positions. Fractures and sprains increased the mean skin surface temperature by 1.519% (p = 0.008) and 0.971% (p = 0.055) respectively compared with the uninjured wrist. The mean temperature difference between flat and elevated positions for fractures was 0.268% and − 0.1291% for sprains. This difference was statistically significant for fracture (p = 0.004) but not sprain (p = 0.500). The temperature differences recorded by thermal imaging between fractured and sprained wrists may assist in differentiation of these injuries.

Operational stages involved from thermal video recording to generation of results

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Acknowledgements

We would like to thank the children and their carers who very kindly participated in the study as without their support this work would have been impossible. We also would like to thank the clinicians at the Sheffield Children’s Hospital, UK, for welcoming research in the clinical environment, helping with recruitment and screening.

Funding

This study was part funded by a grant from The Children’s Hospital Charity to SR.

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Authors and Affiliations

  1. University of Sheffield, Sheffield, UK

    Charlotte Reed

  2. Sheffield Hallam University, Sheffield, UK

    Reza Saatchi

  3. Emergency Department, Sheffield Children’s Hospital, Sheffield, S10 2TH, UK

    Derek Burke & Shammi Ramlakhan

  4. Gibraltar Health Authority, Gibraltar, UK

    Derek Burke

Authors
  1. Charlotte Reed
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  2. Reza Saatchi
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  3. Derek Burke
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  4. Shammi Ramlakhan
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Corresponding author

Correspondence to Shammi Ramlakhan.

Ethics declarations

A favourable ethical opinion was attained from the Sheffield NHS Research Ethics Committee (NREC) (IRAS project ID: 253940). Dedicated patient information sheets for children and carers were used to provide details of the study’s purpose, procedure and the patients’ rights. Informed assent (for children) and consent (for carers) were obtained prior to the recordings taking place. The patient information and recordings were anonymised prior to storage and processing in accordance with the Data Protection Act (2018).

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Reed, C., Saatchi, R., Burke, D. et al. Infrared thermal imaging as a screening tool for paediatric wrist fractures. Med Biol Eng Comput 58, 1549–1563 (2020). https://doi.org/10.1007/s11517-020-02167-z

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  • DOI: https://doi.org/10.1007/s11517-020-02167-z

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