편마비후 견관절 수부 증후군에서 적외선 체열촬영 검사의 진단적 유용성

Abstract

Shoulder-hand syndrome is characterized by pain, vasomotor instability, and tenderness, mainly in the distal upper extremity. The pathophysiologic mechanism of this syndrome is not yet proven. The purpose of this study is to determine the usefulness of digital infrared thermographic imaging for the early and objective diagnosis of shoulder-hand syndrome. Prospectively seventy seven patients of post cerebrovascular accident were analyzed. In this study the subjects were divided into the control group and the study group. The control group consisted of 49 hemiplegic patients without clinical symptom of shoulder-hand syndrome. The study group consisted of 28 hemiplegic patients who had the clinical symptom and showed diffuse uptake in the hand and wrist on delayed image of radionuclide scan.

In the control group, digital infrared thermographic imaging study revealed hypothermia on the involved upper extremity, compared with the opposite intact side (p<0.01). In the study group, it revealed hyperthermia on the dorsal hand and distal forearm of involved upper extremity (p<0.001), compared with the opposite intact side. In patients with stroke onset within 3 months, the sensitivity of digital infrared thermographic imaging for the diagnosis of shoulder-hand syndrome was 86.7% and the specificity was 100% in the dorsal hand. Digital infrared thermographic imaging is considered to be very sensitive to the changes of skin temperature in shoulder-hand syndrome and can be applied as a useful diagnostic modality for the early detection.