Differentialdiagnostische Möglichkeiten der Thermographie bei der generalisierten Tendomyopathie (GTM)
Fibromyalgia is a clinically defined pain syndrome, characterized by multiple symmetric tender points, especially at richly innervated tendon insertions. Additionally, muscular trigger points may be painful. According to American authors, painful trigger points can be detected by thermography as hyperthermal spots (5–10 mm diameter, +1 °C). This is especially true for acute pain syndromes. In chronic pain the thermal profile may be inverted such that painful points are more or less hypothermic. At present, the data for thermal phenomena at trigger points are still controversial, i.e., a typical thermal image is not known. However, thermography is able to show thermal differences (hyper-/hypothermia) at any location described as painful by the patient.
Thermal phenomena in fibromyalgia never follow a segmental distribution, as in the case of referred pain (e.g., of the small spine joints), or as in nerve compression syndromes (e.g., herniated spinal-disk or peripheral-nerve compression).
The special value of thermography is the possibility of differentiating fibromyalgia from other diseases of the locomotor system which cause pain similar to that of fibromyalgia, e.g., inflammation, nerve compression, sympathetic nerve disturbances, vasospastic or occlusive arterial disease, for which there are clear thermal indications.
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