CLINICAL SIGNIFICANCE OF THERMOGRAPHY AT CHRONIC GOUTY ARTHRITIS
DOI:
https://doi.org/10.11603/1811-2471.2019.v0.i2.10368Keywords:
chronic gouty arthritis, thermographyAbstract
In recent years, interest in the study of gout has increased significantly due to the high level of its morbidity and frequent relapses, which leads to prolonged disability. Important clinical and pathogenetic manifestations of gout include violation of thermoregulation and regional blood flow. However, the thermography of gouty arthritis remains little studied.
The aim of the study – the clinical and pathogenetic reasoning of the possible application of thermography for the diagnosis of chronic gouty arthritis.
Materials and Methods. The study included 40 stationary patients with chronic gouty arthritis (37 men and 3 women) aged 45 to 74 years. The duration of the disease was more than 5 years. The thermographic examination was performed using the ULIRvision TI 120 thermal imager (Zhejiang Ulirvision Technology Co., China), following the manufacturer's recommendations.
Results. It was established that with an increase of the disease duration there is an increase in the number of affected joints, tofus, increased intensity of pain for VAS, the frequency of exacerbations during the year. On the thermograms obtained in the phase of exacerbation of chronic gouty arthritis, a zone of intense hyperthermia, which in size exceeded the apparent hyperemia, was visible. Borders of erythema are clear. ΔT was 1.8–5.4 °C. In reconvalescents at discharge from the hospital, the area of hyperthermia smaller and less intense, the contours were not clear. ΔT was 0.7–3.3 °C. Two months after discharge, most patients had hyperthermia at low intensity over the studied joint. ΔT was 0.6–1 °C.
Conclusions. In gouty arthritis in the exacerbation phase there is intense infrared radiation from the affected area. On thermograms, it manifests itself as a thermal asymmetry with a zone of hyperthermia that exceeds the area of inflammation. In the phase of exacerbation of this disease, the change in the radiation temperature in the inflammation center, as compared with symmetrical healthy parts of the skin varies from 1.8 to 5.4 °C. In the period of remission of chronic gouty arthritis, in the absence of clinical changes from the affected joint, there is an increase in the local temperature, indicating the presence of subclinical inflammation.
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