PMC2374475_01
Changes in three-dimensional and thermal measurements after intra-articular steroid injection. A 9-year-old female with polyarticular juvenile idiopathic arthritis underwent imaging before and 5 days after an intra-articular steroid injection of the left wrist. (a) Pre- and post-injection wrist region of interest and volume with dorsal (solid white arrow) and lateral (dashed white arrow) swelling evident in the pre-injection image. (b) Pre- and post-injection surface distance color map demonstrating pre-injection swelling (solid arrows) that resolves post-injection (dashed arrows). (c) Pre- and post-injection thermograms and heat distribution index (HDI). (d) Pre- and post-injection relative frequency distributions of temperatures. SDI, surface distribution index.
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F4
The decision was made to proceed with intra-articular steroid injection, and the patient underwent imaging prior to the procedure (Figure 4). A reduction in volume of 2 ml, representing a 10% decrease, was noted (Figure 4a). No significant change in SDI was observed, although the area of decreased swelling was evident on the surface color map (Figure 4b). HDI values changed from 1.9 C prior to the injection to 1.1 C after the injection (Figure 4c), associated with narrowing of her temperature frequency distribution (Figure 4d).
PMC2374475_02
Changes in three-dimensional and thermal measures during rheumatoid arthritis flare. A 45-year-old Caucasian female with well-controlled rheumatoid arthritis was imaged. Nine days later, she developed an acute flare of her symptoms and was re-imaged on day 10. (a) Pre- and post-flare wrist region of interest and volume. (b) Pre- and post-flare surface distance color map demonstrating post-flare swelling (dashed arrow), not present in pre-flare image (solid arrow). (c) Pre- and post-flare thermograms and heat distribution index (HDI). (d) Pre- and post-flare relative frequency distributions of temperatures. SDI, surface distribution index.
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F5
Wrist volume increased between sessions by 4 ml, representing an 8.7% increase from baseline (Figure 5a). Wrist SDI increased between sessions by 1.4 mm, representing an 18.4% increase, along with an obvious change in surface contour as reflected by the surface color map (Figure 5b). The patient's wrist HDI increased from 1.5 C to 2.5 C (Figure 5c). Relative frequency distribution went from narrow to broad (Figure 5d).