The InfraJoint Protocol for Infrared Thermography of the Hands and Wrists in the Assessment of Inflammatory Arthropathies
Resumo
The diagnostic differentiation between inflammatory arthropathies and non-inflammatory musculoskeletal disorders is challenging in primary care and in resource-constrained settings, where access to ultrasonography with power Doppler, computed tomography, or magnetic resonance imaging is limited. Infrared thermography of the hands and wrists is a promising low-cost, contactless and ionizing-radiation-free modality to support this triage, but its broader clinical adoption is held back by the absence of standardized acquisition protocols. In this paper we contribute (i) the InfraJoint acquisition protocol, which combines a static phase and a dynamic cooling/rewarming phase over a controlled support, and (ii) preliminary results from an ongoing cohort of patients with rheumatoid arthritis and healthy controls, characterizing the clinical profile of the recruited population and the pattern of joint involvement.
Referências
Alpay-Kanıtez, N., Celik, S., and Bes, C. (2019). Polyarthritis and its Differential Diagnosis. European Journal of Rheumatology, 6(4):167–173.
American Academy of Thermology (2024). Guidelines for Neuro-Musculoskeletal Infrared Medical Thermology and Sympathetic Skin Response (SSR) Studies. [link]. Accessed: 2026-04-24.
Crepeau, J. (2009). A Brief History of the T4 Radiation Law. In Proceedings of the ASME Heat Transfer Summer Conference, pages 59–65. ASMEDC.
Foster, Z. J., Day, A. L., and Miller, J. (2023). Polyarticular Joint Pain in Adults: Evaluation and Differential Diagnosis. American Family Physician, 107(1):42–51.
Gatt, A., Formosa, C., Cassar, K., Camilleri, K. P., De Raffaele, C., Mizzi, A., Azzopardi, C., Mizzi, S., Falzon, O., Cristina, S., and Chockalingam, N. (2015). Thermographic Patterns of the Upper and Lower Limbs: Baseline Data. International Journal of Vascular Medicine, 2015(1):831369.
Gatt, A., Mercieca, C., Borg, A., Grech, A., Camilleri, L., Gatt, C., Chockalingam, N., and Formosa, C. (2019). A Comparison of Thermographic Characteristics of the Hands and Wrists of Rheumatoid Arthritis Patients and Healthy Controls. Scientific Reports, 9(1):17204.
Kow, J. and Tan, Y. K. (2023). An Update on Thermal Imaging in Rheumatoid Arthritis. Joint Bone Spine, 90(3):105496.
Miranda, E., Aryuni, M., and Irwansyah, E. (2016). A Survey of Medical Image Classification Techniques. In 2016 International Conference on Information Management and Technology (ICIMTech), pages 56–61. IEEE.
Miyoshi, M. and Liu, S. (2018). Collagen-Induced Arthritis Models. In Rheumatoid Arthritis. Methods in Molecular Biology, vol. 1868, pages 3–7. Humana Press.
Ospelt, C. and Frank-Bertoncelj, M. (2017). Why Location Matters — Site-specific Factors in Rheumatic Diseases. Nature Reviews Rheumatology, 13(7):433–442.
Pauk, J., Wasilewska, A., and Ihnatouski, M. (2019). Infrared Thermography Sensor for Disease Activity Detection in Rheumatoid Arthritis Patients. Sensors, 19(16):3444.
Poudel, P. and Lappin, S. L. (2023). Inflammatory Arthritis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. NBK507704. Available from: [link].
Tan, Y. K., Hong, C., Li, H., Allen Jr, J. C., and Thumboo, J. (2020). Thermography in Rheumatoid Arthritis: A Comparison with Ultrasonography and Clinical Joint Assessment. Clinical Radiology, 75(12):963.e17–963.e22.
Tan, Y. K. and Lim, G. H. (2024). Assessment of Joint Inflammation at the Wrist of Patients with Rheumatoid Arthritis: Thermography Findings Closely Mirror those from Ultrasonography. Clinical and Experimental Rheumatology, 42(5):1051–1056.
Tan, Y. K., Lim, G. H., Ooi, C. C., Ma, V. C., and Vora, B. M. K. (2024). Thermographic and Ultrasound Assessment in Patients with Rheumatoid Arthritis: Can Thermography Detect Subclinical Synovitis at the Wrist? BMC Rheumatology, 8(1):62.
Tattersall, G. J. (2016). Infrared Thermography: A Non-Invasive Window into Thermal Physiology. Comparative Biochemistry and Physiology Part A: Molecular & Integrative Physiology, 202:78–98.
Triantafyllias, K., Clasen, M., De Blasi, M., Berres, M., Nikolodimos, E., and Schwarting, A. (2024). Performance of a Novel High-Resolution Infrared Thermography Marker in Detecting and Assessing Joint Inflammation: A Comparison with Joint Ultrasound. Clinical and Experimental Rheumatology, 42(9):1802–1811.
American Academy of Thermology (2024). Guidelines for Neuro-Musculoskeletal Infrared Medical Thermology and Sympathetic Skin Response (SSR) Studies. [link]. Accessed: 2026-04-24.
Crepeau, J. (2009). A Brief History of the T4 Radiation Law. In Proceedings of the ASME Heat Transfer Summer Conference, pages 59–65. ASMEDC.
Foster, Z. J., Day, A. L., and Miller, J. (2023). Polyarticular Joint Pain in Adults: Evaluation and Differential Diagnosis. American Family Physician, 107(1):42–51.
Gatt, A., Formosa, C., Cassar, K., Camilleri, K. P., De Raffaele, C., Mizzi, A., Azzopardi, C., Mizzi, S., Falzon, O., Cristina, S., and Chockalingam, N. (2015). Thermographic Patterns of the Upper and Lower Limbs: Baseline Data. International Journal of Vascular Medicine, 2015(1):831369.
Gatt, A., Mercieca, C., Borg, A., Grech, A., Camilleri, L., Gatt, C., Chockalingam, N., and Formosa, C. (2019). A Comparison of Thermographic Characteristics of the Hands and Wrists of Rheumatoid Arthritis Patients and Healthy Controls. Scientific Reports, 9(1):17204.
Kow, J. and Tan, Y. K. (2023). An Update on Thermal Imaging in Rheumatoid Arthritis. Joint Bone Spine, 90(3):105496.
Miranda, E., Aryuni, M., and Irwansyah, E. (2016). A Survey of Medical Image Classification Techniques. In 2016 International Conference on Information Management and Technology (ICIMTech), pages 56–61. IEEE.
Miyoshi, M. and Liu, S. (2018). Collagen-Induced Arthritis Models. In Rheumatoid Arthritis. Methods in Molecular Biology, vol. 1868, pages 3–7. Humana Press.
Ospelt, C. and Frank-Bertoncelj, M. (2017). Why Location Matters — Site-specific Factors in Rheumatic Diseases. Nature Reviews Rheumatology, 13(7):433–442.
Pauk, J., Wasilewska, A., and Ihnatouski, M. (2019). Infrared Thermography Sensor for Disease Activity Detection in Rheumatoid Arthritis Patients. Sensors, 19(16):3444.
Poudel, P. and Lappin, S. L. (2023). Inflammatory Arthritis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. NBK507704. Available from: [link].
Tan, Y. K., Hong, C., Li, H., Allen Jr, J. C., and Thumboo, J. (2020). Thermography in Rheumatoid Arthritis: A Comparison with Ultrasonography and Clinical Joint Assessment. Clinical Radiology, 75(12):963.e17–963.e22.
Tan, Y. K. and Lim, G. H. (2024). Assessment of Joint Inflammation at the Wrist of Patients with Rheumatoid Arthritis: Thermography Findings Closely Mirror those from Ultrasonography. Clinical and Experimental Rheumatology, 42(5):1051–1056.
Tan, Y. K., Lim, G. H., Ooi, C. C., Ma, V. C., and Vora, B. M. K. (2024). Thermographic and Ultrasound Assessment in Patients with Rheumatoid Arthritis: Can Thermography Detect Subclinical Synovitis at the Wrist? BMC Rheumatology, 8(1):62.
Tattersall, G. J. (2016). Infrared Thermography: A Non-Invasive Window into Thermal Physiology. Comparative Biochemistry and Physiology Part A: Molecular & Integrative Physiology, 202:78–98.
Triantafyllias, K., Clasen, M., De Blasi, M., Berres, M., Nikolodimos, E., and Schwarting, A. (2024). Performance of a Novel High-Resolution Infrared Thermography Marker in Detecting and Assessing Joint Inflammation: A Comparison with Joint Ultrasound. Clinical and Experimental Rheumatology, 42(9):1802–1811.
Publicado
01/06/2026
Como Citar
POUBEL, Rodrigo et al.
The InfraJoint Protocol for Infrared Thermography of the Hands and Wrists in the Assessment of Inflammatory Arthropathies. In: WORKSHOP DE TERMOGRAFIA COMPUTACIONAL E IA PARA APLICAÇÕES MÉDICAS - SIMPÓSIO BRASILEIRO DE COMPUTAÇÃO APLICADA À SAÚDE (SBCAS), 26. , 2026, Ouro Preto/MG.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2026
.
p. 510-521.
ISSN 2763-8987.
DOI: https://doi.org/10.5753/sbcas_estendido.2026.26491.
