Feasibility of applying infrared thermal imaging for home monitoring of arthritis in children

Abstract Background Telemedicine has improved access to pediatric rheumatology care. A disadvantage to using virtual modality for evaluation of children with arthritis is the lack of an in-person, hands-on physical exam. Thermal imaging has been studied in the clinical setting with promising results...

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Main Authors: Stephen Wong, Nivrutti Bhide, Erin Balay-Dustrude, Erin Sullivan, Joshua Scheck, Ian Muse, Kevin Cain, Debosmita Biswas, Savannah C. Partridge, Yongdong Zhao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Pediatric Rheumatology Online Journal
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Online Access:https://doi.org/10.1186/s12969-025-01096-1
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author Stephen Wong
Nivrutti Bhide
Erin Balay-Dustrude
Erin Sullivan
Joshua Scheck
Ian Muse
Kevin Cain
Debosmita Biswas
Savannah C. Partridge
Yongdong Zhao
author_facet Stephen Wong
Nivrutti Bhide
Erin Balay-Dustrude
Erin Sullivan
Joshua Scheck
Ian Muse
Kevin Cain
Debosmita Biswas
Savannah C. Partridge
Yongdong Zhao
author_sort Stephen Wong
collection DOAJ
description Abstract Background Telemedicine has improved access to pediatric rheumatology care. A disadvantage to using virtual modality for evaluation of children with arthritis is the lack of an in-person, hands-on physical exam. Thermal imaging has been studied in the clinical setting with promising results. This study aims to determine the feasibility of procuring at-home thermal imaging, measuring the variability of in-home skin temperature measurements over three consecutive days, and to compare these measurements at home to ones obtained in the clinic setting. Methods Children with knee pain and/or swelling for a week or longer were enrolled and imaged with a smartphone-attached FLIR ONE PRO and Fluke handheld cameras followed by imaging with a FLIR camera at home for 3 consecutive days. Joint exam performed in the office was used as gold standard for joint assessment. A previously validated metric of temperature after within-limb calibration (TAWiC), defined as the temperature differences between the knee joint and ipsilateral mid-tibia, was used for all imaging studies. Results Fifty-three patients were enrolled and thirty-eight completed the imaging acquisition at home with analyzable images. When evaluating images of the knee and mid-tibia regions, images collected at home compared to in-office demonstrated consistently lower absolute temperatures. However, the calibrated temperatures (TAWiC) of the anterior and lateral views of the knee showed mild to moderate correlation across 3 days between home-acquired images and office-acquired images (r = 0.58, 0.26, 0.24 and r = 0.36, 0.41, 0.42, respectively). The sensitivity and specificity of detecting arthritis of the knee using TAWiC adjustments from previously defined thresholds were similar regardless of the setting of image acquisition (0.44 and 0.79). Conclusions This study demonstrates the feasibility of applying TAWiC for arthritis detection through a smartphone-based infrared thermal camera operated by families at home. Further investigation on a larger scale is needed prior to implementation of this process in the telemedicine setting.
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spelling doaj-art-c2b973eddfe84e75a9217bcc91d64a722025-08-20T03:42:20ZengBMCPediatric Rheumatology Online Journal1546-00962025-07-012311810.1186/s12969-025-01096-1Feasibility of applying infrared thermal imaging for home monitoring of arthritis in childrenStephen Wong0Nivrutti Bhide1Erin Balay-Dustrude2Erin Sullivan3Joshua Scheck4Ian Muse5Kevin Cain6Debosmita Biswas7Savannah C. Partridge8Yongdong Zhao9Pediatric Rheumatology, Department of Pediatrics, Seattle Children’s Hospital, University of WashingtonCenter for Clinical and Translational Research, Seattle Children’s Research InstitutePediatric Rheumatology, Department of Pediatrics, Seattle Children’s Hospital, University of WashingtonCenter for Clinical and Translational Research, Seattle Children’s Research InstitutePediatric Rheumatology, Department of Pediatrics, Seattle Children’s Hospital, University of WashingtonPediatric Rheumatology, Department of Pediatrics, Seattle Children’s Hospital, University of WashingtonDepartment of Statistics, School of Nursing, University of WashingtonDepartment of Radiology, University of WashingtonDepartment of Radiology, University of WashingtonPediatric Rheumatology, Department of Pediatrics, Seattle Children’s Hospital, University of WashingtonAbstract Background Telemedicine has improved access to pediatric rheumatology care. A disadvantage to using virtual modality for evaluation of children with arthritis is the lack of an in-person, hands-on physical exam. Thermal imaging has been studied in the clinical setting with promising results. This study aims to determine the feasibility of procuring at-home thermal imaging, measuring the variability of in-home skin temperature measurements over three consecutive days, and to compare these measurements at home to ones obtained in the clinic setting. Methods Children with knee pain and/or swelling for a week or longer were enrolled and imaged with a smartphone-attached FLIR ONE PRO and Fluke handheld cameras followed by imaging with a FLIR camera at home for 3 consecutive days. Joint exam performed in the office was used as gold standard for joint assessment. A previously validated metric of temperature after within-limb calibration (TAWiC), defined as the temperature differences between the knee joint and ipsilateral mid-tibia, was used for all imaging studies. Results Fifty-three patients were enrolled and thirty-eight completed the imaging acquisition at home with analyzable images. When evaluating images of the knee and mid-tibia regions, images collected at home compared to in-office demonstrated consistently lower absolute temperatures. However, the calibrated temperatures (TAWiC) of the anterior and lateral views of the knee showed mild to moderate correlation across 3 days between home-acquired images and office-acquired images (r = 0.58, 0.26, 0.24 and r = 0.36, 0.41, 0.42, respectively). The sensitivity and specificity of detecting arthritis of the knee using TAWiC adjustments from previously defined thresholds were similar regardless of the setting of image acquisition (0.44 and 0.79). Conclusions This study demonstrates the feasibility of applying TAWiC for arthritis detection through a smartphone-based infrared thermal camera operated by families at home. Further investigation on a larger scale is needed prior to implementation of this process in the telemedicine setting.https://doi.org/10.1186/s12969-025-01096-1Juvenile idiopathic arthritisPediatric rheumatologyKneeInfrared thermal imagingTelemedicine
spellingShingle Stephen Wong
Nivrutti Bhide
Erin Balay-Dustrude
Erin Sullivan
Joshua Scheck
Ian Muse
Kevin Cain
Debosmita Biswas
Savannah C. Partridge
Yongdong Zhao
Feasibility of applying infrared thermal imaging for home monitoring of arthritis in children
Pediatric Rheumatology Online Journal
Juvenile idiopathic arthritis
Pediatric rheumatology
Knee
Infrared thermal imaging
Telemedicine
title Feasibility of applying infrared thermal imaging for home monitoring of arthritis in children
title_full Feasibility of applying infrared thermal imaging for home monitoring of arthritis in children
title_fullStr Feasibility of applying infrared thermal imaging for home monitoring of arthritis in children
title_full_unstemmed Feasibility of applying infrared thermal imaging for home monitoring of arthritis in children
title_short Feasibility of applying infrared thermal imaging for home monitoring of arthritis in children
title_sort feasibility of applying infrared thermal imaging for home monitoring of arthritis in children
topic Juvenile idiopathic arthritis
Pediatric rheumatology
Knee
Infrared thermal imaging
Telemedicine
url https://doi.org/10.1186/s12969-025-01096-1
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