Thermographic and sonographic findings in patients with ankle joint and foot pain: a retrospective study for the period from january 2010 to july 2025.

Abstract

Starting point: This retrospective study evaluated all patients who were admitted to our institution with ankle or foot pain between January 2010 and July 2025, from which we included only those who presented a positive sonographic finding and also underwent thermographic examination.

Group: A total of 579 patients met the inclusion criteria, comprising 253 women aged 3–86 years (mean age 48.5 years) and 326 men aged 5–86 years (mean age 44.3 years).

Methods: Across this cohort, 803 positive sonographic findings were identified. Based on their morphological characteristics, these findings were categorized into solid-structure abnormalities, which accounted for 56% of all findings and included osteophytes, calcifications, ossifications and tophi; fluid-containing lesions, representing 19% and encompassing bursae, cysts, ganglia, joint effusion and oedema; tendinopathies, enthesopathies and ligamentous abnormalities, which constituted 15%; traumatic lesions such as ruptures, fractures, avulsions and TEP, representing 6%; defects and aseptic osteonecrosis, accounting for 2%; and growing pains, also accounting for 2%.

Results: Among the 579 patients with documented sonographic abnormalities, 81% exhibited an altered thermographic temperature distribution. Hyperthermia on the symptomatic side was recorded in 74% of these patients, whereas hypothermia was present in 7%, and 19% demonstrated a normal thermal pattern on the symptomatic side when compared with the contralateral ankle and foot.

Conclusions: The combined use of physical and thermographic assessment together with sonographic examination provides greater diagnostic accuracy than thermography or sonography alone. This integrated approach enables the selection of more targeted and individualized treatment strategies.