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The basic neuroanatomic and physiologic aspects of the sympathetic outflow to the limbs are reviewed and correlated with the somatic sensory dermatomes. The recent literature is considered. A thermocouple thermometer was used to test 30 normal patients and 87 patients with clinically proven nerve root lesions. Thermographic imaging of the sensory dermatome is not plausible, and thermography is not recommended for clinical documentation of painful conditions of the neck, back, or limbs. [ABSTRACT FROM AUTHOR]

The diagnosis and treatment of heat stroke has relied on rectal temperature monitoring. A twenty-year retrospective review of heat stroke and heat exhaustion victims reveals a 24% mortality and a 33% incidence of overcooling. An experimental protocol using hot and cool baths demonstrates marked rectal temperature lag during periods of rapid body heating and cooling. Auditory canal temperature measurements provide an attractive alternative to rectal temperature measurement during rapid temperature change. Rectal temperature monitoring of heat stroke victims is not recommended. This work suggests that shivering during treatment of heat stroke might be the result of vascular and brain overcooling with elevated rectal temperatures.

The methods of evaluating thermal injury after marathon events in temperate weather have produced considerable debate. In this article, the authors address the problem of monitoring internal temperature during periods of rapid change.

The value of thermography in evaluating neck and back pain is assessed based on a simple random sample of 405 Active Fellows of the American Academy of Orthopaedic Surgeons. There were 316 responses to the survey with 293 Fellows indicating that they evaluate neck and back pain. Eighteen use thermography and seven find thermography helpful in their practice. The use of thermography in the courtroom to document painful conditions of the neck and back is not supported by this survey.

The authors describe a new form of sit-up exercise that should isolate the abdominal muscles and eliminate the hip flexors from participation. Such an exercise should be useful in low back pain rehabilitation programs. Demonstration of the sit-up in an L1 paraplegic man, along with measurements of intra-abdominal pressures generated during exercise are also included.