Hot Stuff: Thermal Imaging- Aids in Cellulitis Diagnosis
Aaron M. Drucker and Vincent Piguet, Journal of Investigative Dermatology (2018), Volume 138484
Click to read the abstract
Hot Stuff: Thermal Imaging- Aids in Cellulitis Diagnosis
Aaron M. Drucker and Vincent Piguet, Journal of Investigative Dermatology (2018), Volume 138484
Cellulitis is commonly misdiagnosed, with resultant health care expenditures and complications from antibiotic over prescription. Ko et al. evaluate the use of thermal imaging to aid in the diagnosis of cellulitis, with promising results. Limitations include a small sample size and questionable applicability to bilateral leg findings, where cellulitis is unlikely regardless of temperature differential. Nevertheless, this technology has potential to improve patient care.
Main findings
- Cellulitis is the most common skin condition with which patients present to the emergency department and it is frequently misdiagnosed.
- In a study of presumed lower limb cellulitis diagnosed in the emergency department of a tertiary care center, 31% of patients were misdiagnosed, leading to unnecessary antibiotic prescriptions and hospitalizations (Weng et al., 2017).
- This publication commented on the use of a thermal imaging device attached to a smart phone.
- Impressively, a temperature difference of 0.47C was able to differentiate cellulitis from pseudocellulitis with 96.6% sensitivity, 45.5% specificity, 82.4% positive predictive value, and 83.3% negative predictive value. In the confirmatory cohort, 100% of cellulitis patients and 50% of pseudocellulitis patients were correctly diagnosed.
- A limitation of the thermal imaging technique is its application in patients with bilateral skin findings.
- This study provides promising technology with major potential impact on the individual.
