Pochaczevsky R
Am J Sports Med. 1987 May-Jun;15(3):243-50. doi: 10.1177/036354658701500309.
Posttraumatic pain is often associated with complex disturbances of the sympathetic nervous system which also controls microcirculation of the skin. Circulatory skin changes are in turn reflected by altered superficial thermal emission, which can be reliably imaged by thermography. Examples of classic thermographic patterns associated with commonly occurring injuries and detected along cutaneous distributions of peripheral nerves or spinal root dermatomes are presented. Thermographic abnormalities may also occur in ondermatomal distributions to involve an entire hand, foot, or extremity as observed in reflex sympathetic dystrophy. Such thermographic findings often appear before skin or roentgenographic changes become manifest and lead to earlier diagnosis. Prompt and more effective treatment, particularly in reflex sympathetic dystrophy, may thereby be initiated so that full blown, difficult to manage, chronic disability may be averted. The diagnosis of malingering may also be strengthened or suspected if thermographic studies together with other examinations are normal.
创伤后疼痛常与交感神经系统的复杂紊乱相关，而交感神经系统也控制着皮肤的微循环。循环性皮肤变化又通过体表热发射的改变得以反映，热成像可对其进行可靠成像。本文展示了与常见损伤相关的典型热成像模式实例，这些实例是沿着外周神经的皮肤分布或脊髓神经根皮节检测到的。热成像异常也可能出现在非皮节分布区域，累及整个手部、足部或肢体，如反射性交感神经营养不良所见。此类热成像结果通常在皮肤或X线变化显现之前出现，从而实现更早诊断。由此可启动及时且更有效的治疗，尤其是在反射性交感神经营养不良的情况下，以便避免发展为全面、难以处理的慢性残疾。如果热成像研究与其他检查结果均正常，也可能强化或引发对诈病的怀疑。
