Infrared thermal imaging can be a very useful diagnostic tool for the pregnant patient who suffers from spinal pain with or without radicular complaints. It is especially useful in a patient who has suffered a cervical or spinal acceleration/deceleration injury (whiplash).
Infrared imaging or thermography (IRT) is non-invasive, painless, and risk free. Interside cutaneous temperature differences has been documented by several authors to be very small when temperature differences exceed 0.8oC from right to left homologous parts it is considered abnormal. Other authors have been published in peer reviewed scientific journals on the good reliability, predictive value, sensitivity and specificity of IRT. IRT is reflective of sympathetic dysautonomia which can accompany articular, myofascial, peripheral nerve and nerve root injury. Most of these syndromes can reflect different patterns which makes IRT useful to differentially diagnose articular, myofascial and radicular origins of pain. This then helps the clinician better direct treatment options. Since the pregnant patient cannot have x-rays, MRI, CT or other invasive tests, IRT is well equipped as a diagnostic tool for this population of patients.
In the case of whiplash injuries, where multiple structures can be affected (i.e., disc, muscle, ligament, joint, nerve, etc.), IRT is very helpful. However, as with any test, thermography does not stand alone and must be correlated with the clinical exam findings and patient history, much like x-ray, CT, or MRI.
IRT findings can be utilized in the pregnant patient not only to help formulate a diagnosis but also to help monitor and clinically assess the patient's progress and response to care.
Figures 1,2,3 are scans of a patient who was pregnant and suffered from low back and leg pain. As the scans show, there are thermal asymmetries in the lower extremities suggestive of nerve fiber dysfunction secondary to a disc protrusion. Subsequently, a lumbar CAT scan disclosed an L4/L5 disc herniation.
Figures 1, 2, 3
Figures 4,5,6 are thermography scans of a pregnant patient who also complained of back and leg pain. The scans display relative thermal symmetry. Subsequent to delivery, a lumbar MRI scan was essentially normal.
figures 2A/2B
Conclusion
Thermography is a useful noninvasive, risk free, pain free, diagnostic took for the pregnant patient who suffers from spinal pain and/or radiculopathy.
David BenEliyahu, DC
Selden, New York 11784
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