Table 1

Infrared thermography in paediatrics summary table

Researchers (ref.)YearStudy designParticipantsKey findings
Skin temperature
 Kolosovas-Machuca et al 3 2011Distribution of skin temperature in Mexican children.25 childrenReduced physiological variability in skin temperature of children, compared with similar study in adults.
 Symonds et al 4 2012Thermal imaging to assess age-related changes of skin temperature within the supraclavicular region co-locating with brown adipose tissue in healthy children.26 patients of all agesChild cohort had significantly greater difference in skin temperature following cold challenge, compared with adolescents and adults (p<0.05).
Fever screening
 Selent et al 6 2013Mass screening for fever in children a comparison of 3 infrared thermal detection systems.855 childrenSensitivity 76.4%–83.7% and specificity of 79.4%–86.3%, across the three cameras, for detecting fever.
 Chan et al 7 2004Screening for fever by remote-sensing infrared thermography camera.176 patients of all agesSensitivity 83% and specificity 88%, for detecting fever by IRT.
 Fortuna et al 8 2010Accuracy of non-contact infrared thermometry versus rectal thermometry in young children evaluated in the emergency department for fever.200 childrenIRT overestimated temperature in afebrile patients and underestimated temperature in febrile patients, compared with rectal thermometry (p<0.01).
Monitoring vital signs
 Heimann et al 9 2013Infrared thermography for detailed registration of thermoregulation in premature infants.10 premature infantsIRT showed significant increase in head and leg skin temperature, following 90 min of neonatal skin-to-skin care (p<0.05).
 Anderson et al 10 1990Use of thermographic imaging to study babies sleeping at home.Five infantsIRT was used to measure skin temperature in sleeping infants, showing significant heat loss in the head and hands.
 Abbas et al 11 2011Neonatal non-contact respiratory monitoring based on real-time infrared thermography.Seven premature infantsMean respiration rate reported as 44.92 by IRT, compared with 43.77 by ECG measurement.
 Abbas et al 12 2014Intelligent neonatal monitoring based on a virtual thermal sensor.10 neonatesFace-tracking success rate ranged from 74% (p<0.01) to 89% (p<0.01).
 Al-Khalidi et al 13 2015Respiratory rate measurement in children using a thermal imaging camera.20 childrenRespiratory monitoring by IRT and standard methods had a correlation coefficient of 0.994.
 Elphick et al 14 2015Thermal imaging method for measurement of respiratory rate.50 adults, 20 childrenRespiratory monitoring by IRT and standard methods had a correlation coefficient of 0.88–0.998 in adults and 0.578–0.999 in children.
 Goldman et al 15 2012Nasal airflow and thoracoabdominal motion in children using infrared thermographic video processing.17 childrenRespiratory monitoring by IRT and standard methods had a correlation coefficient of 0.976.
IRT successfully identified patients with respiratory disease (p=0.0125).
 Rice et al 16 2010Infrared thermal imaging (thermography) of the abdomen in extremely low birthweight infants.13 infantsInfants with radiographic NEC had lower abdominal temperature than those without disease (p<0.05).
 Knobel et al 17 2011Thermoregulation and thermography in neonatal physiology and disease.Review of the literature, assessing feasibility of IRT for recording temperature in ELBW infants.
Authors concluded future research would benefit from IRT.
Trauma and wound healing
 Sanchis-Sánchez et al 18 2015Infrared thermography is useful for ruling out fractures in paediatric emergencies.133 childrenIRT had sensitivity 91% and specificity 88% for identifying fracture.
 Silva et al 19 2012Early assessment of the efficacy of digital infrared thermal imaging in pediatric extremity trauma.51 childrenIRT matched the site of pain in 73% patients and matched 7 out of 11 fracture sites.
 Ćurković et al 20 2015Medical thermography (digital infrared thermal imaging) in paediatric forearm fractures – a pilot study.19 childrenIRT found average temperature of the affected arm was 1.17°C higher than the unaffected arm 1 week after injury, reducing to 0.14°C difference 1 month after injury.
 Saxena et al 21 2008Infrared thermography: experience from a decade of pediatric imaging.483 children102 patients with haemangioma: positive temperature differential 1.5°C in rapidly progressing cases, but those that underwent complete recovery had a temperature differential of <0.5°C.
Five patients with partial amputation showed temperature differential 2.5°C following surgery, reducing to 1.8°C after 48 hours.
30 patients affected by burns showed 2.8°C temperature differential following complete healing.
Six patients with varicocele showed 4.1°C temperature differential in affected side.
61 patients with thoracic wall abnormalities showed temperature differential of 2.4°C across affected area.
42 patients with abscess, infection and gangrene: areas of abscess showed 3.6°C temperature differential across affected side.
 Morcate et al 22 1996Post-traumatic gaseous gangrene in childhood: a case report.One infantCase study of 2-year-old child with gas gangrene, where IRT helped identify the area of amputation required.
 Saxena et al 23 1999Thermography of Clostridium perfringens infection in childhood.One infantSame case study as Morcate et al. (1996).
 Medina-Preciado et al 24 2013Non-invasive determination of burn depth in children by digital infrared thermal imaging.13 childrenIRT identified 100% of superficial and deep burns, whereas clinical assessment identified 83.33% of superficial and 42.85% of deep burns.
Haemangioma and varicocele
 Garcia-Romero et al 25 2014The role of infrared thermography in evaluation of proliferative infantile hemangiomas. Results of a pilot study.10 childrenAverage temperature differential across haemangioma was 2.5°F at baseline, reducing to −0.2°F after 6 months.
 Mohammad et al 26 2014Infrared thermography to assess proliferation and involution of infantile hemangiomas a prospective cohort study.42 childrenAverage temperature differential across haemangioma was 1.9°F at baseline, increasing to 2.5°F at 3 months, before decreasing to 0.2°F at 18.5 months.
 Iwata et al 27 1992Thermography in a child with varicocele.One childPreoperative temperature measurements, performed with IRT, showed affected scrotum to be 4°C warmer than the unaffected side. No temperature differential was found at 39 days or 12 months postoperatively.
Dermatology
 Martini et al 28 2002Juvenile-onset localized scleroderma activity detection by infrared thermography.40 childrenIRT had sensitivity of 92% and specificity of 68% in detecting scleroderma.
 Castillo-Martínez et al 29 2013Use of digital infrared imaging in the assessment of childhood psoriasis.One childCase study of a 9-year-old boy with psoriatic lesions.
IRT found increased skin temperature in areas affected by psoriasis.
 Kashiwagi et al 30 2013Thermography for evaluation of localized scleroderma treated with methotrexate and corticosteroid.one childCase study in a 9-year-old child with scleroderma.
Skin temperature was higher around the affected skin, with IRT images showing reduced temperature following treatment but no quantitative measurements given.
Diabetes mellitus
 Zotter et al 31 2003Rewarming index of the lower leg assessed by infrared thermography in adolescents with type I diabetes mellitus.25 adolescentsIRT found different rewarming indexes in patients with diabetes, compared with age-matched controls. The first and fifth toe and the inner ankle produced statistically significant differences, following 10 min cold challenge testing (p<0.05).
Joint inflammation
 Lasanen et al 32 2015Thermal imaging in screening of joint inflammation and rheumatoid arthritis in children.58 childrenSurface temperature of inflamed and non-inflamed ankle joints were statistically different (p=0.044). No significant difference was found across inflamed and non-inflamed knee joints.
Neurology
 Goetz et al 33 2005Thermography – a valuable tool to test hydrocephalus shunt patency.54 childrenIRT identified hydrocephalus shunt patency in 88.9% of patients.
 Zurek et al 34 2008Influence of mechanical hippotherapy on skin temperature responses in lower limbs in children with cerebral palsy.16 adolescent childrenIRT found no benefit in limb perfusion following intervention, in patients with cerebral palsy.
 Coben et al 35 2009Sensitivity and specificity of long wave infrared imaging for attention-deficit/hyperactivity disorder.190 patients of all agesIRT had a sensitivity of 65.71% and a specificity of 94%, in identifying individuals with ADHD.
Ophthalmology
 Kaercher et al 36 2015Diagnosis of x-linked hypohidrotic ectodermal dysplasia by meibography and infrared thermography of the eye.14 adults, 12 children, 8 infantsIRT had a sensitivity of 66.7% in identifying XLHED, compared with 100% and 72.7% of two best alternative methods.
Allergy screening
 Clark et al 37 2007Facial thermography is a sensitive and specific method for assessing food challenge outcome.24 childrenPositive food challenge in patients with egg allergy resulted in median nasal temperature differential 1.7°C higher than that of the control (p<0.01). IRT identified outcome of food challenge with 91% sensitivity and 100% specificity.
 Clark et al 38 2012Thermographic imaging during nasal peanut challenge may be useful in the diagnosis of peanut allergy.16 childrenIn children with peanut allergy, statistically significant mean temperature increase of 0.9°C (95% CI 0.34°C to 1.45°C) observed following nasal food challenge, compared with placebo.
Anaesthetics
 Cheema et al 39 1994Thermography: a noninvasive assessment of pediatric thoracic epidural blocks.One childCase study of an 8-year-old girl undergoing thoracic epidural block. IRT indicated clearly delineated temperature change of 0.9°C, from the dermatomes of T4 to T10, suggesting the region of epidural blockade.
  • IRT, infrared thermography; NEC, necrotising enterocolitis; ELBW, extremely low birth weight.