Thermal imaging of an ice burn over the patella following clinically relevant cryotherapy application during a clinical research study

Abstract

Objectives: The use of cryotherapy in soft tissue injury is still largely based on anecdotal rather than empirical evidence. The objective of this case report is to present thermal imaging data from a mild ice burn sustained during a clinical research project. Design: Case report. Case description: A 43-year-old male participant recruited to take part in an ongoing cryotherapy research project sustained a mild ice burn, resulting in visible blanching of the skin over the affected area and a transient burning sensation. The burn occurred unexpectedly during a tightly controlled experimental procedure, employing protocol from current clinical practice. Three participants had already successfully completed the study with no adverse reactions when the ice burn occurred. Outcome measures: Outcome measures were; patella skin-fold, modality temperature pre and post application, baseline thermal image, and thermal imaging data over the knee at a rate of 1 image min_1 during a 25-min re-warming period. Results: The participant recorded a patella skin-fold of just 7 mm. Baseline skin surface temperature was 29.4 1C. Skin surface temperature (Tsk) decreased by 17.9 1C following cold application. During the 25-min re-warming period Tsk increased 11.8 1C. Conclusions: Twenty minutes of cryotherapy application may be too long over an anatomically bony area. Clinicians should consider thermal gradient as part of their clinical decision making process, which would be influenced by increased ambient temperature, pathology, and also lower modality temperature.