Thermography in posttraumatic pain

Abstract

Posttraumatic pain is often associated with complex disturbances of the sympathetic nervous system which also controls microcirculation of the skin. Circulatory skin changes are in turn reflected by altered superficial thermal emission, which can be reliably imaged by thermography. Examples of classic thermographic pat terns associated with commonly occurring injuries and detected along cutaneous distributions of peripheral nerves or spinal root dermatomes are presented. Ther mographic abnormalities may also occur in onderma tomal distributions to involve an entire hand, foot, or extremity as observed in reflex sympathetic dystrophy. Such thermographic findings often appear before skin or roentgenographic changes become manifest and lead to earlier diagnosis. Prompt and more effective treatment, particularly in reflex sympathetic dystrophy, may thereby be initiated so that full blown, difficult to manage, chronic disability may be averted. The diag nosis of malingering may also be strengthened or sus pected if thermographic studies together with other examinations are normal.