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Postural Screening for Adolescent Idiopathic Scoliosis With Infrared Thermography
Adolescent idiopathic scoliosis (AIS) is a multifactorial, three-dimensional (3D) deformity of the spine and trunk. AIS can appear and sometimes progress during any of the rapid periods of growth in children. Research has shown that the early detection of scoliosis is effective in preventing its progression; therefore, school scoliosis screening is recommended by researchers. Early detection reduces the number of cases that require surgery through non-surgical interventions. Therefore, school scoliosis screening (SSS) should be conducted for the purpose of early detection.
Figure 1. IR image of a non-scoliotic subject-symmetrical temperature distribution along the paraspinal muscles.
This study originated from requests for an alternative screening tool to optical techniques for SSS as an additional test aside from the FBT. This new method must meet the needs of the SSS program and the school environment and is required to be accurate, reproducible and reasonably sensitive with reliable specificity. Recently, infrared (IR) thermography has been applied in numerous clinical studies. IR technology as a non-invasive clinical assessment tool is able to identify diseases with good reliability and sensitivity by comparing the temperature distribution difference between regions of interest. Therefore, IR thermography was specifically examined in this study as an additional detection method. Thus, an IR camera would be the best device for identifying differences in the paraspinal muscles through the use of temperature in scoliotic subjects.
Figure 2. Comparison of IR images of a scoliotic subject with X-rays.
The objective of this study was, therefore, to explore the possibility of using IR thermography to evaluate IR emissions from subjects to detect abnormalities in temperature distribution in their paraspinal muscles. It is hypothesized that IR emission should be comparatively more even in non-scoliotic subjects than in their scoliotic counterparts, as the former have a more balanced paraspinal muscle profile. For the muscle group that is tested through identical means, the temperature difference between the muscles on the left and right sides of the body is assumed to be minimal in non-scoliotic subjects.
Figure 3. Regions of interest computed software. 1 is the trapezius, 2 is the latissimus dorsi, and 3 is the quadratus lumborum.
The advantage of using an IR camera for performing IR thermography is its ability to quantify the surface topography of subjects in terms of temperature distribution, which may be associated with muscle activity. The data obtained for analysis are objective, with a cut-of value that can be justified based on further clinical trials with blind testing. The emissivity of the IR camera can also be adjusted, which will better ensure accuracy of the measurements at different locations. The IR camera can also be easily transported and saves on the cost of hiring a professional clinician to perform the screening. Personnel with the ability and skills to operate the IR camera can perform the screening. Therefore, this study supports the use of this technology in school screenings of idiopathic scoliosis and its application as an additional tool because it is non-invasive, efficient, reliable and portable. This study still provides evidence of the feasibility of incorporating IR thermography into school screening for scoliosis.
Garcia Kwok, JoanneYip, Kit-LunYick, et al. Postural Screening for Adolescent Idiopathic Scoliosis with Infrared Thermography. Scientific Reports. 7(14431):1-8, 2017.