Thermology Uncovered – a three part series by Sophie Gent
by guest blogger Sophie Gent MD SyncThermology
Thermography has become a popular imaging option that is easily accessible to horse owners without the need for a veterinary referral, however it has fast become a problem for many veterinary practices as the technology is unregulated and therefore difficult to control. Often thermal screening services are carried out by technicians who use a wide range of imaging technology, making it increasingly difficult for horse owners to select which service they should use. Equipment can now vary from thermal cameras that fit onto the back of a smart phone to clinical grade imaging equipment which is used in human medicine. Image interpretation by veterinary surgeons generally does not come as standard and horses are often imaged in less than perfect screening environments, however clients are still proactively sourcing “thermographers” to investigate lameness before calling their vet. As a general rule, many horse owners do not understand what the technology is detecting and more importantly its limitations before outsourcing services. Raising awareness, expanding research and educating the industry is a challenge many veterinary professionals are now working to improve.
The biggest misconception for horse owners is that thermography is a standalone test which will provide a diagnosis whilst avoiding expensive vet bills… but in reality, thermography can only provide an indication rather than a diagnosis and will normally warrant further targeted investigation. To use this technology correctly there first needs to be an understanding of its benefits and limitations before deciding if it should be used as part of a clinical evaluation or treatment plan.
Thermology measures the autonomic nervous system and detects physiological (functional) abnormalities and can graphically record inflammatory and neurological processes, all helpful information when data is collected and interpreted accurately. “Hot spots” are irrelevant to a point, the interpretation of this technology it is all about pattern (pathology) recognition, temperature differential and comparative studies, coupled with extensive veterinary experience.
Many aspects must come together to achieve accurate and reliable results, just like all other diagnostic tests, results should be interpreted and reported on by trained veterinary surgeons who can reliably factor previous and current clinical signs into their analysis of images. Thermography is a test of physiology, so without an in depth knowledge of the autonomic system the correct analysis can be difficult; owners wouldn’t expect their horses’ x-ray or MRI scan to be reported on by anyone other than a vet and thermography should be no different.
To achieve the most accurate results the technology used for testing should be of the highest clinical specificity designed for physiological imaging and data collection should be done by experienced technicians under veterinary referral. If clients do not want to investigate results further or work with their vet then this will become the biggest limitation. Thermography cannot see structure (anatomy) so without the use of additional diagnostics or veterinary examination, the ability to correlate findings and confirm a diagnosis is limited.
In most cases dynamic testing (a work-up or lunging) should be carried out. One of the main benefits of imaging physiology is that things change and dysfunction can be well highlighted when the body is put under physiological stress. Imaging horses without exercise can limit the reliability of results but is unfortunately commonly seen in the industry. Exercising patients (dependent on veterinary advice) induces reactions; these reactions very often help to confirm or rule out primary pathology and provide a better understanding of whether exercise induced or exacerbated a condition. Images should be collected pre and post exercise and in controlled environments.
To learn more about thermology, SyncThermology run free CPD’s and workshops around the UK. Go to www.syncthermology.com for more information.
Keep an eye out for the next blog which will explain the benefits of thermology…