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Pan American Journal of Medical Thermology
DOI: http://dx.doi.org/10.18073/2358-4696/pajmt.v2n2p86-89
Pan Am J Med Thermol 2(2): 86-89 86
Abstract – Thermology is flourishing in Brazil
and it is use is very recently compared to other
countries. The steady growth of this medical
specialty is encouraged by a climate of
collegial harmony between physicians,
thermologists and engineerings. In Brazil,
there is multispecialty interest in the use of
thermography in the prevention, diagnosis, and
treatment of disorders particularly influenced
by pain, vascular, breast, ophthalmologic and
sport medicine´s researches. The author
disclose the main recently investigations at
Brazil.
Keywords: Chronical pain, vascular, breast,
sport medicine, ophthalmology, thermography;
diagnoses
Resumo – A termologia está florescendo no
Brasil e é de uso muito recentemente
comparado a outros países. O crescimento
constante dessa especialidade médica é
incentivado por um clima de harmonia
acadêmica entre médicos, termologistas e
engenheiros. No Brasil, há um interesse de
várias especialidades no uso da termografia na
prevenção, diagnóstico e tratamento de
doenças, particularmente influenciados pelas
pesquisas na área de dor, angiologia,
mastologia, oftalmologia e medicina do
esporte. O autor divulga as principais e mais
recentes investigações no Brasil.
Palavras-chave: Doenças crônicas, vascular,
mamas, medicina do esporte, oftalmologia,
termografia, diagnóstico.
1. PAIN APPLICATIONS
In Brazil, there is multispecialty interest in the
use of thermography in the prevention, diagnosis,
and treatment of disorders – particularly related
to the nerves, muscles, bones and brain – that
may produce temporary or permanent
impairment. Many physicians, including
neurologists, neurosurgeons, anesthesiologists,
orthopedists, sport medicine physicians,
physiotherapist and dentists are using
thermography on a routine basis for the
evaluation of chronic pain. Infrared imaging
measurements can provide a useful, non-invasive
and nonionizing examination for diagnosis of
myofascial trigger points (MTPs) in muscles
when compared with ultrasonography. Haddad et
al from Department of Oral Radiology, School of
Dentistry (FMUSP) are identifying and
correlating MTPs in the masticatory muscles,
using thermography and algometry (1). The face
has trusted and fixed thermo-anatomical points,
which can be assessed as reference for
thermography analysis. Assignment of
anatomical reference is a key step in diagnosis of
facial diseases and also MTPs. Although
thermography can assess physiological and
functional aspects of the face such as
microcirculation and autonomous nervous system
function. It may determine a fixed hot landmark
as the inner canthus of the eyes, which are related
to the site of superficial supra-orbital vessels
Brazilian Current Studies of Medical Thermology
Marcos Leal Brioschi1
1. President of Brazilian Medical Thermology Association
E-mail: termometria@yahoo.com.br
Pan American Journal of Medical Thermology
DOI: http://dx.doi.org/10.18073/2358-4696/pajmt.v2n2p86-89
Pan Am J Med Thermol 2(2): 86-89 87
projections. Dr Haddad identified, mapped and
quantified facial thermo-anatomical points in
healthy adult population that can be used as a
reference craniometric landmark for
thermography studies (2).
It has also been stimulated the use of
thermography to evaluate neuropathic pain. We
are conducting thermographic studies for distal
diabetic neuropathy identification by tests that
induce thermoregulatory responses as the
rewarming index after cold stress testing (3). We
are also conducting studies of thermographic
identification of traumatic neuromas post-
amputation and comparing with ultrasound
images. Thermography can guide injection of
botulinum toxin for local treatment with good
clinical response. Vascular cold patch is a useful
prognostic index to follow up by thermography
migraine patients and is a neurogenic
inflammatory response that can also be inhibited
with botulinum toxin. We are conducting and
evaluating this neurological response.
Also are being conducted experimental
studies in animals. Laser therapy technique is a
noninvasive method which has shown to be
clinically effective in reducing the sensitivity to
pain and therefore in improving the quality of life
of patients with neuropathic pain, pain that is
characterized by various changes and metabolic
chemical mediators. Dr Oliveira from Laboratory
of Functional Neuroanatomy of Pain Department
of Anatomy Institute of Biomedical Science
(FMUSP) is examining the effects of application
of Laser on soreness induced by chronic
constriction (CCI) of the sciatic nerve of Wistar
rats, to evaluate the involvement of substance P
and TRPV1 and analyze tissue perfusion by
thermography technique after laser therapy. Our
preliminary results indicate an improvement in
the group treated with laser compared with CCI
group (no treatment) in behavioral tests for
allodynia, thermal and mechanical hyperalgesia.
Thus, we suggest that laser therapy improves
neuropathic pain induced by CCI, but there are
still studies demonstrating the involvement of
this technique in maintaining this painful
syndrome and its possible mechanism of action
as a therapeutic intervention.
Professor of Physiology José Cipolla-Neto,
M.D, Ph.D. from the Department of Physiology
and Biophysics, Neurobiology Lab, Institute of
Biomedical Sciences, FMUSP is conducting
research on the influence of melatonin on
thermoregulation and obesity. To this approach is
being used thermography to monitor response of
brown adipose tissue (BAT) before and after
melatonin administration and also in
pinealectomized patients. The results are being
compared with positron emission tomography-
computed tomography (PET-CT) scan using 2-
[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) to
measure glucose utilization associated with BAT
mitochondrial respiration and also magnetic
resonance imaging (MRI). Infrared thermography
may record the activation of BAT, Dr Brioschi
post-doctoral at FMUSP identified in the
fibromyalgia pain syndrome (FMS) a
characteristic “mantle signal” related to BAT
dysfunction. Hands or feet immersion in water at
20ºC provocative test evaluates the
aforementioned activation. Although not a
definitive diagnosis, the phenomenon of the
mantle and peripheral vasoconstriction may
support the clinical diagnosis, having an
important role in monitoring patients with FMS,
as markers of autonomic dysfunction, present in
this disease (4).
Oriental medical practitioners are beginning
to use thermography as a graphic display of
treatment effect. Recently Dr Freire, one of our
recent experts in thermology, reported on
thermographic hands vasomotor inhibition
characteristics of LI-4 acupuncture point.
2. VASCULAR APPLICATIONS
There is growing interest in the use of
thermography in the prevention of
cerebrovascular disease and heart attacks. Dr
Edmar Santos of Albert Einstein Israelite
Hospital recently reported on his work in
cerebrovascular applications. The fingertip
temperature rebound by infrared thermography
monitoring after brachial artery compression
showed good correlation with the Framingham
score for stroke (FRSS) in 10 years. Recently,
the measurement of endothelial function by
thermography through the microcirculation in
patients emerged as a useful tool to evaluate the
presence of atherosclerotic plaque in different
vascular beds. From these results we concluded
that the study of endothelial function by
thermography can be used as a surrogate marker
to improve stratification of cardiovascular risk
and might also be useful for the evaluation of
therapeutic strategies (5,6).
Pan American Journal of Medical Thermology
DOI: http://dx.doi.org/10.18073/2358-4696/pajmt.v2n2p86-89
Pan Am J Med Thermol 2(2): 86-89 88
3. BREAST APPLICATIONS
Although breast thermography is being
performed in some Brazilian centers most is
being doing in the research field by universities,
most of whom are improving diagnostic criteria
based upon biopsied cancer cases. The biologist
Keli Morais of the Center for Research and Self-
Sustaining Energy Development, Parana Federal
University, recently defended his PhD who
presented the results of the work entitled: An
infrared image based methodology for breast
lesions screening. The new methodology applied
obtained lesion detection efficiency with 96%
accuracy rate in the study group of 47 women
with malignant breast tumors. In this study the
control group without lesions contained 101
women which ensured reliability in sample
representation. The advisors were Prof. José
Viriato Vargas (PhD) and Dr. Marcos Brioschi.
These results contributed to the development of a
robust methodology, inexpensive and universal
access to the population that will contribute to the
prevention of deaths of women due to breast
cancer. The results demonstrate that the method
has potential for utilization as a noninvasive
screening exam for individuals with breast
complaints, indicating whether the patient should
be submitted to a biopsy or not (7).
The other research carried out at the same
center analyzed the thermal behavior of the
breasts during the cycle temperatures. The
average temperature of the breast in healthy
women had a direct relationship with the central
and ambient temperature and can be estimated
mathematically. It is suggested that an equation
could be used in clinical practice for estimating
the normal breast reference temperature in young
women, regardless of the day of the cycle, and
thus assist in evaluation of anatomical studies (8).
4. OPHTHALMOLOGICAL
APPLICATIONS
Obstructions in the lacrimal pathways quite
often require accurate and reliable image
scanning for confirmation and documentation.
Infrared thermal imaging is a resource that
complements diagnosis; it does not require
touching the patient or applying contrast
materials and has been used in various medical
procedures for decades. However, there have
been few studies in the literature about its use in
ophthalmology Dr. Machado from Department of
Opthalmology and Visual Sciences, Paulista
School of Medicine (EPM), Federal University of
São Paulo (UNIFESP) has developed a close-up
magnification thermography for ophthalmologic
applications. Recently we published a case of
dacryocystitis where the obstruction of the
lacrimal punctum was so acute that conventional
dacryocystography could not be used. The
authors have successfully reported the use of
thermography as a complementary propaedeutic
and will discuss the method they used (9).
5. SPORT MEDICINE
Prof Neves and his group have recently
published essential findings for the field of
thermography studies in sport medicine. Their
first work involved soccer players (10) and the
second, rugby players (11).
Neves and his collaborators published some
methodological findings that impact directly the
way to analyze thermal images acquired in sports
science (12). They demonstrated that subjects
with lower subcutaneous fat layer have a higher
skin temperature variation rate during exercise
than those with higher subcutaneous fat layer
(13). In another study they showed that althought
ultrasound images have high sensibility for
muscle physiological changes on the first 24
hours after exercise, on the other hand,
thermography had higher sensibility for muscle
physiological changes than ultrasound images
from 24 to 96 hours after training (14). And
thermography seems to be an efficient,
trustworthy and secure method in order to
monitoring skin temperature during cryotherapy
application. Evidence supports the use of
thermography in detriment of contact methods
(15).
Because of these multicenter researches and
applications, the Brazilian thermographic exams
have a whole body characteristic examination at
the main medical centers (16). They are focused
on the full evaluation of the patients, not only
specific areas, evaluating a series of possibilities
after exposing the patients’ thermoregulatory
response at a well-controlled lab. This
characteristic has increased the reputation and the
value of thermography as a significant and useful
diagnostic method in the Medicine practice in our
country. Thermology is flourishing in Brazil and
its use is very recently compared to other
countries. The steady growth of this medical
specialty is encouraged by harmony between
Pan American Journal of Medical Thermology
DOI: http://dx.doi.org/10.18073/2358-4696/pajmt.v2n2p86-89
Pan Am J Med Thermol 2(2): 86-89 89
physicians, thermologists and engineerings. With
the encouragement and support of the Brazilian
National Council for Scientific and
Technological Development, Brazilian
Thermology Association and the universities,
patients in Brazil are reaping increasing benefits
from the science of thermology.
REFERENCES
1. Haddad DS, Brioschi ML, Arita ES.
Thermography and myofascial trigger points
Dentomaxillofacial Radiology 41, 621–629,
2012.
2. Haddad DS, Vardasca R, Brioschi ML, Arita
ES. Study of the facial surface skin thermal
distribution by infrared thermography: facial
thermoanatomy, 2015 in press.
3. Balbinot LF, Robinson CC, Achaval M,
Zaro MA, Brioschi ML. Repeatability of infrared
plantar thermography in diabetes patients: a pilot
study. J Diabetes Sci Technol. 2013 Sep
1;7(5):1130-7.
4. Brioschi ML, Yeng LT, Araujo JO,
Pezzucchi MZ, Teixeira MJ. Modulação da Dor
na Síndrome Fibromiálgica: um Distúrbio
Termorregulatório? Pan Am J Med Thermol 1(2):
71-801, 2014.
5. Santos EB, Bianco HT, Brioschi ML.
Thermography in Assessing Cardiovascular Risk.
Pan Am J Med Thermol 2(1): 23-25. 2015.
6. Santos EB, Bonasso C, Balbinot LF,
Brioschi ML, Bianco HT, Raposo Filho JJF.
Risco de Acidente Vascular Encefálico: avaliação
pela termografia cutânea por radiação
infravermelha. Pan Am J Med Thermol 1(1): 23-
30, 2014.
7. Morais KCC, Vargas JVC, Reisemberger G,
Freitas FNP, Oliari SH, Brioschi ML, Louveira
MH, Spautzd C, Dias FG, Gasparin Jr P, Budel
VM, Cordeiroe RAG, Schittinie APP, Neto CD.
An infrared image based methodology for breast
lesions screening. Infrared Physics &
Technology, 2015 in press.
8. Reisemberger de Souza GAG, Brioschi ML,
Vargas JVC, Morais KCC, Dalmaso Neto C,
Neves EB. Breast reference temperature:
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Allemann N. Using thermography for an
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BIOIMAGING 2015 - 2nd International
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Engineering Systems and Technologies,
BIOSTEC 2015 2015; Lisboa: SCITEPRESS.
13. Neves, Eduardo Borba, Moreira, Tiago
Rafael, Lemos, Rui Jorge, Vilaça-Alves, José,
Rosa, Claudio, & Reis, Victor Machado. (2015).
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Rafael, Lemos Rui, Vilaça-Alves José, Rosa
Claudio, Reis Victor Machado. Using skin
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[cited 2015 Dec 15] ; 21( 5 ): 350-354.
15. Filipe Matos, Eduardo Borba Neves, Marco
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Vilaça-Alves. The use of thermal imaging to
monitoring skin temperature during cryotherapy:
A systematic review
Infrared Physics & Technology, Volume 73,
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