Thermographic evaluation of the painful shoulder in the hemiplegic patient.

In this study, we investigated the applicability of thermography as a technique for evaluating the painful postcerebrovascular accident (CVA) shoulder in hemiplegic patients. A thermographic series was taken of the upper extremities and upper trunk of 27 female subjects. The four groups we evaluated were nonhemiplegic subjects (n = 9), post-CVA subjects with recovered function (n = 6), hemiplegic subjects with upper extremity motor impairment (n = 6), and hemiplegic subjects with both motor impairment and ipsilateral shoulder pain (n = 6). The data revealed a normal thermographic series in 8 of the 9 nonhemiplegic subjects, but only in 1 of the 18 post-CVA subjects. The majority of the abnormal thermographic series of post-CVA subjects showed a 1 degree to 5 degree C coolness on the involved side. No consistent thermographic patterns emerged that could be related to the severity or location of pain. Further studies are needed to evaluate the efficacy of thermography as a means of determining the relationship between ipsilateral post-CVA coolness and hemiplegic shoulder pain.