Biological Imaging and Sensing from Basic Techniques to Clinical Application - Biological Imaging and Sensing - page 43

shows a case of L5/S1 lumbar-disk herniation. The area of pain coincides with
the area of lower temperature indicated by the L5/S1 sensory dermatome.
It has been agreed that the area of chronic radiculopathic pain coincides
with the lower-temperature regions and that the dermatomal thermatome is
a good screening tool for the detection of radiculopathic complaints.
Myotomal Thermatome. Recent research has shown that some low-temp-
erature areas can indicate muscular lesions. In particular, areas of low-temp-
erature skin on the surfaces of the body trunk and the medial side of the
extremities may indicate a reduced blood flow or the lower temperature of
a muscle under the skin. Low-temperature zones produced as a result of
whiplash injury or cervical radiculopathy indicate the muscle lesion directly.
The myotomal thermatome is defined as a thermogram expression of muscle
lesions.
Metabolic Thermatome. Thermographic observation can detect abnormal
temperature distributions. Many thermographers consider that hot or cold
spots indicate metabolic abnormalities, and the detection and measurement
of hot spots is still an important factor in the differential diagnosis of tumors
and for making prognoses for inflammatory diseases. The term metabolic
thermatomes refers to a metabolically dominant thermal image. However,
the metabolic image is usually combined with the skin blood-flow image,
which may lead to ambiguity. A thermal stress test is therefore required in
order to distinguish between those two phenomena.
Fig. 1.42. A functional angiologic thermatome of a left-side Horner's syndrome by
cervical syringomyelia (the right-side image is a time-sequential subtraction image
between the before and after images of the left-side stellate ganglion block)