Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine · 2025
Diagnostic accuracy of infrared thermography and textural features in patellar tendinopathy: optimizing ROI selection in athletes.
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Molina-Payá F J, Montero-Navarro S, Orts-Ruiz C, Salar-Andreu C, Brotons-Mas J R, Sánchez-Mas J
Аннотация
OBJECTIVES: To evaluate the diagnostic accuracy of infrared thermography (IT) using temperature difference (ΔT) and gray-level co-occurrence matrix (GLCM)-based textural parameters for detecting patellar tendinopathy (PT) in athletes, and to determine the optimal region of interest (ROI) size for analysis.
DESIGN: Cross-sectional study following STARD criteria.
SETTING: Physical therapy center with controlled environmental conditions.
PARTICIPANTS: 54 athletes (27 with unilateral PT; 27 healthy controls).
MAIN OUTCOME MEASURES: Temperature differences (ΔT) and GLCM features (energy, homogeneity, contrast, correlation, entropy) from thermal images of tendon and knee ROIs.
RESULTS: Athletes with PT showed higher ΔT in the tendon ROI (0.5 ± 0.36 °C vs. 0.2 ± 0.20 °C; d = 0.77; p = 0.013). Among GLCM parameters, tendon ROI correlation (TCOR) differed significantly between groups (p = 0.042). Diagnostic performance analysis identified ΔT as the best single variable (AUC 0.83; sensitivity 78 %; specificity 78 %). The ΔT + GLCM combination achieved highest accuracy for tendon ROI (AUC 0.93). The patellar tendon-specific ROI provided better discrimination than the knee ROI.
CONCLUSIONS: IRT combined with GLCM enhances PT diagnostic precision, with the tendon ROI optimal for detecting local physiological differences. This accessible multimodal approach could complement clinical diagnosis in athletes.
DESIGN: Cross-sectional study following STARD criteria.
SETTING: Physical therapy center with controlled environmental conditions.
PARTICIPANTS: 54 athletes (27 with unilateral PT; 27 healthy controls).
MAIN OUTCOME MEASURES: Temperature differences (ΔT) and GLCM features (energy, homogeneity, contrast, correlation, entropy) from thermal images of tendon and knee ROIs.
RESULTS: Athletes with PT showed higher ΔT in the tendon ROI (0.5 ± 0.36 °C vs. 0.2 ± 0.20 °C; d = 0.77; p = 0.013). Among GLCM parameters, tendon ROI correlation (TCOR) differed significantly between groups (p = 0.042). Diagnostic performance analysis identified ΔT as the best single variable (AUC 0.83; sensitivity 78 %; specificity 78 %). The ΔT + GLCM combination achieved highest accuracy for tendon ROI (AUC 0.93). The patellar tendon-specific ROI provided better discrimination than the knee ROI.
CONCLUSIONS: IRT combined with GLCM enhances PT diagnostic precision, with the tendon ROI optimal for detecting local physiological differences. This accessible multimodal approach could complement clinical diagnosis in athletes.