An accurate and reliable method of thermal data analysis in thermal imaging of the anterior knee for use in cryotherapy research.

To develop an anatomic marker system (AMS) as an accurate, reliable method of thermal imaging data analysis, for use in cryotherapy research. Investigation of the accuracy of new thermal imaging technique. Hospital orthopedic outpatient department in England. Consecutive sample of 9 patients referred to anterior knee pain clinic. Not applicable. Thermally inert markers were placed at specific anatomic locations, defining an area over the anterior knee of patients with anterior knee pain. A baseline thermal image was taken. Patients underwent a 3-minute thermal washout of the affected knee. Thermal images were collected at a rate of 1 image per minute for a 20-minute re-warming period. A Matlab (version 7.0) program was written to digitize the marker positions and subsequently calculate the mean of the area over the anterior knee. Virtual markers were then defined as 15% distal from the proximal marker, 30% proximal from the distal markers, 15% lateral from the medial marker, and 15% medial from the lateral marker. The virtual markers formed an ellipse, which defined an area representative of the patella shape. Within the ellipse, the mean value of the full pixels determined the mean temperature of this region. Ten raters were recruited to use the program and interrater reliability was investigated. The intraclass correlation coefficient produced coefficients within acceptable bounds, ranging from .82 to .97, indicating adequate interrater reliability. The AMS provides an accurate, reliable method for thermal imaging data analysis and is a reliable tool with which to advance cryotherapy research.