Entropy enhanced infrared thermography: A radiation free paradigm for precision screening of adolescent idiopathic scoliosis.

Adolescent idiopathic scoliosis (AIS) is a significant challenge to global paediatric health. Early detection and longitudinal monitoring are critical for initiating non operative interventions and preventing irreversible skeletal complications. The aim of this study was to evaluate the efficacy of infrared thermography (IRT) entropy as a non invasive screening technique for adolescent idiopathic scoliosis. To this end, we recruited 203 patients with idiopathic scoliosis and 105 healthy controls, all aged 8 to 18 years. The analysis examined differences in back entropy and temperature values between the idiopathic scoliosis and control groups, whilst calculating the area under the receiver operating characteristic (ROC) curve to assess classification performance. Data analysis was conducted between February and July 2025. A significant disparity was identified between the idiopathic scoliosis group and the control group in both back entropy and temperature values (P < 0.05), with idiopathic scoliosis patients exhibiting markedly reduced entropy and significantly elevated temperatures (for example, in the upper right (UR) region, entropy decreased from 2.63 ± 0.46 bits in the control group to 1.79 ± 0.41 bits in the left convex, while temperature increased from 36.1 ± 0.7 °C to 36.5 ± 0.1 °C). Intragroup analysis revealed good symmetry in both entropy and temperature between the left and right sides of the back in the control group (P > 0.05). Conversely, both entropy and temperature values exhibited significant left right asymmetry in the idiopathic scoliosis group (P < 0.05). ROC curve analysis demonstrated that entropy had good discriminatory ability in distinguishing AIS patients from controls, suggesting its potential utility as an adjunctive screening tool. This approach, being radiation free, effectively addresses the limitation of cumulative radiation exposure inherent in current X ray dependent detection protocols.