The Use of Thermography in the Diagnosis of RSD
December 11, 2011 at 12:21pm
PHILIP GETSON, DO, has been certified by the American Academy of Thermology, the American Herschel Society, the Academy of Neuromuscular Thermology and is a Diplomate of the American Medical Infrared Association. He has lectured extensively in the field of Thermography especially as to its usage in the diagnosis of R.S.D. Below is a summary of his paper on The Use of Thermography in the Diagnosis of CRPS: A Physician’s Opinion. The entire article can be found at http://www.tdinj.com/reflex-sympathetic-dystrophy.html. Dr. Getson’s article appeared in The Pain Practitioner, The Journal of the American Academy of Pain Management, vol. 16, no 1, 2006.
Dr. Getson suggests that healthcare practitioners who diagnose patients make the diagnosis based upon history and physical examination. He also reminds readers that, “because of the wide variation in symptom complexes, not every individual presents with the “classic” symptoms that are frequently associated with CRPS (e.g., temperature change, color change, and hair growth change).”
He believes that triple phase bone scans are only 15% accurate. He also says that EMGs, CAT Scans, MRIs, etc., have no appreciable value in assisting in the diagnosis of CRPS. Dr. Getson believes that Thermography, which has been used since the 1950’s, is most accurate in diagnosing RSD. He points out that in July 2002, the United States Department of Health and Human Services document on Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome, suggests thermography as the diagnostic tool for the evaluation of CRPS.
Dr. Getson has examined thousands of patients using electronic thermography imaging. This type of imaging allows us to look at skin temperature changes that when evaluated correctly can allow the doctor to view the nervous system. “The mechanism of thermal imaging allows for perception of altered skin temperature to one-tenth of one degree centigrade. The lack of symmetry which is out of conformation to dermatomal distribution patterns goes a long way to confirming the clinical diagnosis of CRPS.” Within the first six months of onset the measurement will show the affected side to be warmer, after approximately 6 months the affected side becomes the “cold side”.
Dr. Getson states, “It is fascinating to see patients who offer verbal complaints about one limb, yet manifest thermal abnormalities in an entirely separate area.” He collects data that clearly indicates the migratory pattern of RSD 6-9 months prior to symptomatology in the newly affected area. He can see where it has spread to before the patient has other “classic” symptoms.
Thermography imaging appears to be the best tool for objectification of a clinical diagnosis of RSD. Thermography imaging can also be used as verification to the patients’ symptoms.
