J Korean Med Sci.  2014 Apr;29(4):502-506. 10.3346/jkms.2014.29.4.502.

Digital Thermography of the Fingers and Toes in Raynaud's Phenomenon

• Lim MJ
• Kwon SR
• Jung KH
• Joo K
• Park SG
• Park W

• KMID: 1774454
• DOI: http://doi.org/10.3346/jkms.2014.29.4.502

Abstract

The aim of this study was to determine whether skin temperature measurement by digital thermography on hands and feet is useful for diagnosis of Raynaud's phenomenon (RP). Fifty-seven patients with RP (primary RP, n = 33; secondary RP, n = 24) and 146 healthy volunteers were recruited. After acclimation to room temperature for 30 min, thermal imaging of palmar aspect of hands and dorsal aspect of feet were taken. Temperature differences between palm (center) and the coolest finger and temperature differences between foot dorsum (center) and first toe significantly differed between patients and controls. The area under curve analysis showed that temperature difference of the coolest finger (cutoff value: 2.2degrees C) differentiated RP patients from controls (sensitivity/specificity: 67/60%, respectively). Temperature differences of first toe (cutoff value: 3.11degrees C) also discriminated RP patients (sensitivity/specificity: about 73/66%, respectively). A combination of thermographic assessment of the coolest finger and first toe was highly effective in men (sensitivity/specificity : about 88/60%, respectively) while thermographic assessment of first toe was solely sufficient for women (sensitivity/specificity: about 74/68%, respectively). Thermographic assessment of the coolest finger and first toe is useful for diagnosing RP. In women, thermography of first toe is highly recommended.

Keyword

Raynaud Disease; Thermography; Digital Thermography; Temperature

MeSH Terms

Adult
Diagnosis, Differential
Female
Fingers/*physiology
Humans
Male
Middle Aged
ROC Curve
Raynaud Disease/*diagnosis
Sensitivity and Specificity
Skin Temperature
*Thermography
Toes/*physiology

Figure

• 

  Fig. 1 Thermographic images of palmar aspect of hands (A) and dorsal aspect of feet (B). The region of interest of the distal finger/toe, palm of the hands and dorsum of the feet are drawn in circles. The color chart provides a temperature scale. First, the coolest finger was chosen among the second, third and fourth fingers and then temperature difference was determined by subtracting the temperature at the coolest finger from the temperature at the palm. Temperature difference of first toe was determined in the same manner as in the hand.

• 

  Fig. 2 The distribution of coolest finger in normal controls and RP patients. Rt/Lt denotes right/left, respectively.

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  Fig. 3 The schematic summary of infrared thermography in Raynaud's phenomenon (RP). H, palm of the hand; h, coolest finger; F, dorsum of the foot; f, first toe.

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