Infrared thermography: An investigative tool for detection of subclinical bleed in hemophilia on prophylaxis

Background & objectives Subclinical joint bleed is a matter of concern in individuals with hemophilia on prophylaxis. Ultrasonography (USG) is mostly used for the screening of subclinical bleeds in such individuals but it has its own limitations. Thus a more comprehensive technology is required for the detection of the same. This study undertook to evaluate the efficacy of infrared thermography (IRT) for detection of subclinical joint bleeds and its comparison with ultrasonography and MRI (Magnetic Resonance Imaging), considering MRI as the gold standard. Methods Forty eight asymptomatic individuals with hemophiliacs on prophylaxis and 15 healthy males as controls were recruited. IRT, USG and MRI were done in all participants included in the study. FLIR camera systems were used for the capture of thermograms of the joints in both the study groups. Results The mean of maximum temperature difference>0.5K (ΔT max >0.5K) as compared to a healthy joint was considered as significant. Subclinical bleeds were detected in 23.9, 7.29 and 27.08 per cent participants by IRT, USG and MRI respectively. Sensitivity and specificity of IRT and USG was detected to be 88.4 and 97.67 per cent, and 26.9 and 99 per cent, respectively. Interpretation & conclusions The findings of this study suggest that IRT is an effective tool for detection of subclinical joint bleeds in individuals with hemophilia and can be used for the monitoring of the joints in such individuals.