Image 1: thermal image of the hands of a patient with rheumatoid arthritis.
Rheumatoid arthritis is a chronic autoimmune inflammatory disorder that mainly affects the joints. But rheumatoid arthritis is a systemic disease, and some patients may also see other organs damaged, such as the lungs, heart, skin, eyes, or blood vessels. It is a more frequent disease in women than in men and usually begins between the ages of 25 and 50. It is estimated that between 0.5% and 1% of the population suffers from rheumatoid arthritis (Symmons et al., 2002), which represents about 300,000 people with this disease in Spain.
To this day, the etiology remains unclear, but what we do know is that the pathogenesis involves immunological events that end in chronic inflammation. In some way, this disorder occurs when the patient's immune system mistakenly attacks one or more tissues of his own body.
Most of the patients, have a main affectation in the hands and wrists (Horsten et al., 2010). For these regions, the most frequent problems are described as decreased functionality, inflammation, deformity, pain, weakness and reduced mobility (Adams et al., 2004), specifically in the wrists and hands joints (metacarpophalangeal and proximal interphalangeal). Therefore, the goals of treatment are to prevent or control joint damage, improve hand function, and reduce pain (Williams et al., 2018). Image 2 shows the hand of a rheumatoid arthritis patient.
Image 2: representation of the typical involvement in a with rheumatoid arthritis patient's hand and the inflamed components in a joint.
Photo: Mayo Clinic.
The control and treatment of patients with rheumatoid arthritis should be carried out by Rheumatology units or services. It is a chronic disease and monitoring patients requires regular visits to the specialist, often throughout life. In recent years, technological innovation, together with new biological medications, have greatly improved the quality of life of patients with rheumatoid arthritis.
It is common to confuse both pathologies, although they are totally different diseases. Osteoarthritis is a degenerative disease that appears due to wear and tear on the joints, that usually starts from the age of 60. According to the World Health Organization, osteoarthritis is one of the ten most disabling diseases in developed countries. It is also the main cause of pain and disability (Cross et al., 2014), and the biggest cost of medical care in the elderly (Vina & Kwoh, 2018). In this case, it is a pathology characterized by the fact that the damage is caused by excessive use and consequent joint wear and inflammation. Global estimates are that 9.6% of men and 18.0% of women over the age of 60 have symptomatic osteoarthritis.
However, rheumatoid arthritis, despite being the most common inflammatory polyarthritis, only affects 1% of the population (Symmons et al., 2002). In addition, it does not affect the joint itself, but the lining, causing a painful inflammation.
Can thermography be used to see and quantify the inflammation caused by rheumatoid arthritis? That question was the one that inspired, in 2017, the beginning of a collaboration between the Innovation Unit of the Foundation for Biomedical Research of the Ramón y Cajal Hospital (IRYCIS), the Polytechnic University of Madrid (UPM) and ThermoHuman.
Since then, several data collections and investigations have been carried out to delve into the usefulness of infrared thermography in patients with rheumatoid arthritis and assess possible applications that facilitate the work of rheumatologists and the quality of life of patients. Some of these results have been published in conferences and scientific journals (Loarce-Martos et al., 2019). In addition, these investigations led by the rheumatologist Javier Bachiller Corral have obtained recognition as the NOVARTIS IESE award in 2020.
This project has been focused on helping patients with rheumatoid arthritis to be evaluated remotely (at home) using infrared thermography.
"For a few years the medical part has been worked closely with the technical part, but without ever losing sight of the need of the patient that is the main priority from which this project starts."
- Dr. Javier Bachiller Corral.
Without a doubt, a great milestone in this collaboration has been achieved with the granting of official funding to ThermoHuman by the CDTI ( Center for Industrial Technological Development ) for the development of a specific project focused on this application.
The CDTI is a government body that finances innovation and development projects, promoting technological improvement in Spain. After months of analysis on the utility and viability of the project, a loan for the development of the project has finally been granted for 2 years. This project is focused on validating and developing a system that helps patients with rheumatoid arthritis to be evaluated remotely using infrared thermography. Disruptive technology is implemented in it both in the application of thermography, as in the automatic processing of thermal images, the implementation of algorithms and neural networks to improve the monitoring and diagnostic support of this pathology.
From the ThermoHuman team we are very proud to be able to celebrate the success of this collaboration. We can only thank the Innovation Unit of the Foundation for Biomedical Research of Hospital Ramón y Cajal (IRYCIS) in general and Dr. Javier Bachiller Corral in particular.
Adams, J., Burridge, J., Mullee, M., Hammond, A., & Cooper, C. (2004). Correlation between upper limb functional ability and structural hand impairment in an early rheumatoid population. Clinical Rehabilitation, 18(4), 405-413. https://doi.org/10.1191/0269215504cr732oa
Cross, M., Smith, E., Hoy, D., Nolte, S., Ackerman, I., Fransen, M., Bridgett, L., Williams, S., Guillemin, F., Hill, C. L., Laslett, L. L., Jones, G., Cicuttini, F., Osborne, R., Vos, T., Buchbinder, R., Woolf, A., & March, L. (2014). The global burden of hip and knee osteoarthritis: Estimates from the global burden of disease 2010 study. Annals of the Rheumatic Diseases, 73(7), 1323-1330. https://doi.org/10.1136/annrheumdis-2013-204763
Horsten, N. C. A., Ursum, J., Roorda, L. D., van Schaardenburg, D., Dekker, J., & Hoeksma, A. F. (2010). Prevalence of hand symptoms, impairments and activity limitations in rheumatoid arthritis in relation to disease duration. Journal of Rehabilitation Medicine, 42(10), 916-921. https://doi.org/10.2340/16501977-0619
Loarce-Martos, J., Bachiller-Corral, J., Cuevas, I. F., Quintana, M. S., & Díaz, M. V. (2019). Thu0087 Utility of Infrared Thermography for the Evaluation of Rheumatoid Arthritis. Annals of the Rheumatic Diseases, 78(Suppl 2), 313-314. https://doi.org/10.1136/annrheumdis-2019-eular.5601
Symmons, D., Turner, G., Webb, R., Asten, P., Barrett, E., Lunt, M., Scott, D., & Silman, A. (2002). The prevalence of rheumatoid arthritis in the United Kingdom: New estimates for a new century. Rheumatology (Oxford, England), 41(7), 793-800. https://doi.org/10.1093/rheumatology/41.7.793
Vina, E. R., & Kwoh, C. K. (2018). Epidemiology of osteoarthritis: Literature update. Current Opinion in Rheumatology, 30(2), 160-167. https://doi.org/10.1097/BOR.0000000000000479
Williams, M. A., Srikesavan, C., Heine, P. J., Bruce, J., Brosseau, L., Hoxey-Thomas, N., & Lamb, S. E. (2018). Exercise for rheumatoid arthritis of the hand. The Cochrane Database of Systematic Reviews, 7, CD003832. https://doi.org/10.1002/14651858.CD003832.pub3
ThermoHuman has had the support of the Funds of the European Union and the Community of Madrid through the Operational Programme on Youth Employment. Likewise, ThermoHuman within the framework of the Export Initiation Program of ICEX NEXT, had the support of ICEX and the co-financing of the European Regional Development Fund (ERDF).
Thermohuman has received funding from the Centre for the Development of Industrial Technology (CDTI), in participation with the European Regional Development Fund (ERDF), for the R+D activities involved in creating a new tool, based on thermography, for the prediction and prevention of rheumatoid arthritis. See project detail.
