About Paolo Minafra

Musculoskeletal Radiologist - Sport Medicine Physician

Partial Strain of Adductor Brevis: Thermography, Ultrasound​, ​and MRI study.

about a combined diagnostic approach of muscle injuries using thermography, ultrasound, and MRI exams.

Pain and discomfort in the adductor region of the left thigh immediately after a football match in a professional player. Using thermography, asymmetric distribution of the skin temperature is evident in that site.

I always suggest to execute both MRI and ultrasound examinations; in this case, you can see how it is useful to have a portable device, it allows you to make a preliminary diagnosis before the MRI study and indeed, to observe the follow up of muscle injury directly at the sports center where the team train every day.

The dynamic ultrasound examination shows diffuse muscular edema with a partial tear of the left adductor brevis.adductorBrevisThe perfect combination of all of these imaging procedures is crucial to better plan the recovery period.

8 days after recovery and physiotherapy period that is the situation on MRI exam. Untitled.001The thermography exam shows a better situation but still remains an asymmetric distribution of the skin temperature.final.001

Advertisements

A Thermographic Evaluation of Patellar​ Tendon Partial Tear

about the thermographic evaluation of patellar tendon degeneration

“Many pathological processes in humans manifest themselves as local changes in heat production and also as changes in blood flow pattern at affected organs or tissues”. Vainer BG. FPA-based infrared thermography as applied to the study of cutaneous perspiration and stimulated a vascular response in humans. Phys Med Biol. 2005 Dec 7;50(23): R63–94. 

Since I met the human thermography I always use this kind of evaluation for diagnosis and monitoring of musculoskeletal diseases, together with all the other imaging modalities.

Today I show you the case of a young athlete practicing long jump, with a chronic patellar tendon tendinopathy and partial tear at its proximal attachment.

I always start with clinical examination and thermographic study.

termography-knee

Thermographic study of the painful right knee

termography knee normal

The thermographic evaluation of the healthy left knee shows a difference of 1,5°C less than the right one

Mri Patellar tendon Tendinopathy

Sagittal T1w – Fusion – Stir Mri of the same patient (0.3 Tesla)

I perform the MRI examination to have also the clear depiction of the cortical patellar bone; as you probably know in many similar cases a bone marrow edema is associated at the inferior pole of the patella.

The study is completed with the dynamic ultrasound exam, both in supine and orthostatic position.

The elastosonography evaluation shows less adaptive changes during the dynamic study, as is usually seen in these pathologic conditions.

I believe in integrated imaging study for musculoskeletal pathologies; thermal cameras are user-friendly for anyone is involved in the diagnosis, monitoring, and treatment of these kinds of pathological conditions.