POS0848 EXPLORING THE USE OF THERMOGRAPHY VS. PHYSICAL EXAMINATION IN DETECTING RAYNAUD’S PHENOMENON: AN INVESTIGATIVE STUDY
Authors: L. J. Cajas Santana, J. Recalde Reyes, D. A. Niño, M. A. Perez Hettinga
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Raynaud's phenomenon affects 10 to 20% of individuals associated with autoimmune diseases. A three-step approach based on clinical findings reported by the patient and evidenced by the examiner with well-defined color changes in the fingers has been proposed for diagnosing. However, direct observation can be challenging in clinical practice. Infrared thermography has been evaluated showing promise results. <h3>Objectives:</h3> The main objective of this study was to compare changes detected through physical examination and thermography. <h3>Methods:</h3> We included patients who reported Raynaud's phenomenon. An initial clinical assessment was conducted to determine the presence of distal coldness or changes in coloration, followed by thermography (Thermal Imager LCD 2.4, 8MHz frequency, ranging from -40 to +300 Celsius with an accuracy of 2). Readings were taken on the back of the hand and distally on 10 fingers. A difference of more than 3 degrees was considered abnormal (Figure 1). For those with negative results, conventional hand washing was performed for one minute. Thermography and clinical assessment were repeated 10 minutes later. <h3>Results:</h3> 33 individuals were included. The average age was 54 years, aduration of Raynaud's phenomenon was 7.1(±6.7) years. Diagnoses were 51% systemic sclerosis, 27% Raynaud under study, 12% systemic lupus erythematosus,9% other. Regarding autoantibodies, 11 had centromere pattern ANAs, 2 were SCL-70 positive, 7 had other ANA pattern.36% had puffy fingers, 33% sclerodactyly, 12.5% calcinosis, and 10% had ulcers.14 individuals had capillaroscopy, 35% normal, 28.5% active pattern, and 28.5% late; only 7.1% had an early pattern. Initial abnormal thermography was found in 14 individuals, and hand washing was performed in 19 individuals. The results of this and its relation to the physical examination are presented in Table 1. Initial thermography was abnormal in 21% and 34% of those who did not show coldness or changes in coloration. Conversely, the majority with alterations in the initial examination had abnormal thermography, 100% for coloration and 90% for coldness. Following hand washing, 47% of those who did not present coldness or changes in coloration exhibited abnormal thermography, contrasting with 100% with these findings. <h3>Conclusion:</h3> When there are no abnormalities in the physical examination, patients with abnormal thermography can still be present in up to half of the cases, allowing the detection of an additional number of patients. Conventional hand washing using thermography may be a low-risk means for studying Raynaud's phenomenon. <h3>REFERENCES:</h3> [1] R VJ, D C, L U, Y SG, L RW. Thermography for the detection of Secondary Raynaud's Phenomenon by means of the Distal-Dorsal Distance. Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul;2020:1528-1531. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>