The use of infrared thermography for non-invasive detection of bleeding and musculoskeletal abnormalities in patients with hemophilia: an observational study

Ryohei Kawasaki; Asuka Sakata; Chihiro Hosoda; Suguru Harada; Tetsuhiro Soeda; Yukiko Nishida; Naoki Matsumoto; Kohei Tatsumi; Keiji Nogami; Yasushi Yoshimura; Midori Shima

doi:10.1186/s12959-023-00511-5

The use of infrared thermography for non-invasive detection of bleeding and musculoskeletal abnormalities in patients with hemophilia: an observational study

Thromb J. 2023 Jun 28;21(1):70. doi: 10.1186/s12959-023-00511-5.

Authors

Ryohei Kawasaki^#^{1

2

3}, Asuka Sakata^#¹, Chihiro Hosoda³, Suguru Harada^{1

2}, Tetsuhiro Soeda^{1

2}, Yukiko Nishida^{1

4}, Naoki Matsumoto^{1

2}, Kohei Tatsumi^{1

3}, Keiji Nogami⁵, Yasushi Yoshimura², Midori Shima⁶

Affiliations

¹ Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan.
² Product Research Department, Medical Affairs Division, Chugai Pharmaceutical Co., Ltd., Yokohama, Japan.
³ Advanced Medical Science of Thrombosis and Hemostasis, Nara Medical University, Kashihara, Japan.
⁴ Project Planning and Coordination Department, Translational Research Division, Chugai Pharmaceutical Co., Ltd., Chuo-ku, Japan.
⁵ Department of Pediatrics, Nara Medical University, Kashihara, Japan.
⁶ Medicinal Biology of Thrombosis and Hemostasis, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan. mshima@naramed-u.ac.jp.

^# Contributed equally.

Abstract

Background: In patients with hemophilia (PwH), bleeding often occurs in joints and muscles, and early detection of hemorrhage is important to prevent the onset and progression of mobility impairment. Complex-Image analysis such as ultrasonography, computed tomography, and magnetic resonance imaging are used to detect bleeding. On the other hand, no simple and rapid method to detect the active bleeding has been reported. Local inflammatory responses occur when blood leaks from damaged vessels, and the temperature at the site of active bleeding could be expected to increase in these circumstances, leading to an increase in surrounding skin temperature. Therefore, the purpose of this study was to investigate whether the measurement of skin temperature using infrared thermography (IRT) can be used as a diagnostic aid to detect active bleeding.

Methods: Fifteen PwH (from 6 to 82 years old) complaining of discomfort such as pain were examined. Thermal images were obtained simultaneously at the affected sides and comparable unaffected sides. The average skin temperature of the affected side and of the unaffected side were measured. The temperature differences were calculated by subtracting the average skin temperature at the unaffected side from the affected side.

Results: In eleven cases with active bleeding, the skin temperature at the affected side was more than 0.3 °C higher (0.3 °C to 1.4 °C) compared to the unaffected side. In two cases without active bleeding, there were no significant differences in skin temperature between the affected and unaffected sides. In two cases with previous rib or thumb bone fracture, the skin temperature at the affected side was 0.3 °C or 0.4 °C lower than that of the unaffected side, respectively. In two cases with active bleeding in which longitudinal evaluation was conducted, the difference in skin temperature decreased after hemostatic treatment.

Conclusion: The analysis of skin temperature deference using IRT was a useful supportive tool to readily assess musculoskeletal abnormalities and bleeding in PwH as well as to determine the success of the hemostatic treatment.

Keywords: Bleeding; Hemophilia; Injury; Skin temperature; Thermography.