Arch Phys Med Rehabil. 2003 Sep; 84(9): E26.

Computerized infrared imaging as a tool in monitoring the clinical response to acupuncture treatment in a patient with chronic abdominal pain: A case report. Jeffrey M. Cohen, MD (New York University School of Medicine, New York, NY); Sam S. Wu, MD; Sandra Yuhn, BA; Mathew H. Lee, MD, e-mail: [email protected].

SETTING: Tertiary care hospital. Patient: A 21-year-old woman with poorly controlled type 1 diabetes mellitus and chronic abdominal pain and who was dependent on opioids. Case Description: The patient presented with a 3-month history of abdominal pain. She also complained of weight loss and constant fatigue. Magnetic resonance imaging of her abdomen revealed hepatomegaly and a 4.5cm mass in the right lobe of her liver. Ultrasound of her abdomen revealed an echogenic liver with a solid mass in the right lobe and borderline splenomegaly. Computed tomography-guided liver biopsy revealed a benign tumor. The patient had become dependent on opioids for chronic abdominal pain. She received supportive psychotherapy for management of her pain and depression. She was also referred for acupuncture as an adjunct to her pain management program. Computerized infrared imaging (CII) was performed both before and after acupuncture treatment as a means of objectively assessing her response to acupuncture. Assessment/Results: Initial data from the CII revealed significant asymmetry (>1.0 degrees C), with the right lower quadrant of the abdomen being significantly warmer than the corresponding area on the contralateral side. The patient subsequently underwent acupuncture treatment, which she reported improved the abdominal pain. Follow-up CII of her abdomen revealed no significant asymmetry. Discussion: Acupuncture treatment afforded pain relief for this patient with a benign hepatic tumor and chronic abdominal pain. CII, a simple, noninvasive test that detects cutaneous temperature patterns due to inflammation or sympathetic nervous system activity, objectively documented the patient's response to acupuncture treatment. Conclusion: CII may be a useful tool in objectively monitoring the clinical response to acupuncture treatment in patients with chronic abdominal pain.