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Rheumatology 2002; 41: 1178-1182
© 2002 British Society for Rheumatology

Paediatric Rheumatology

Juvenile-onset localized scleroderma activity detection by infrared thermography

G. Martini, K. J. Murray1, K. J. Howell3, J. Harper2, D. Atherton2, P. Woo1, F. Zulian and C. M. Black3

Paediatric Rheumatology Unit, Department of Paediatrics, University of Padova, Italy
1 Paediatric Rheumatology and
2 Dermatology Units, Great Ormond Street Hospital for Children and
3 Academic Unit of Rheumatology and Connective Tissue Diseases, Royal Free Hospital, London, UK

Abstract

Objective. The aim of this study was to define the clinical utility of infrared thermography in disease activity detection in localized scleroderma (LS).

Methods. We retrospectively reviewed 130 thermal images of 40 children with LS and calculated the sensitivity and specificity of thermography, comparing clinical descriptions of the lesions and contemporary thermographs. The reproducibility of thermography was calculated by using the weighted kappa coefficient to determine the level of agreement between two clinicians who reviewed the thermographs independently.

Results. The sensitivity of thermography was 92% and specificity was 68%. Full concordance between the two clinicians was observed in 91% of lesions, with a kappa score of 0.82, implying very high reproducibility of this technique.

Conclusion. Our results demonstrate that thermography is a promising diagnostic tool when associated with clinical examination in discriminating disease activity, as long as it is applied to lesions without severe atrophy of the skin and subcutaneous fat. Further evaluation is needed to determine whether thermography can predict the future progression of lesions.

KEY WORDS: Juvenile localized scleroderma, Thermography, Assessment.

Notes

Correspondence to: G. Martini, Department of Paediatrics, University of Padova, Via Giustiniani 3, 35128 Padova, Italy.


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