Background/purposeLocalised scleroderma (LS) is the most common form of scleroderma seen in children, and usually presents unilaterally. Infrared thermography (IRT) and laser Doppler (LD) have both been reported to be useful in assessing the active, inflammatory stage of LS. We developed and validated a protocol using these techniques for the assessment of unilateral LS activity in children.MethodWe investigated the spatial variability and repeatability of LD measurements from adult control forearm skin, and the inter- and intra-operator reproducibility of both LD blood flow trace analysis and IRT skin temperature analysis. Software was developed to produce overlay images of thermograms onto digital photographs of skin sites. In a group of seven adult control subjects, we established the normal range for skin temperature and LD blood flow at six standardised sites (forehead, cheek, abdomen, back, arm and leg), and measured contralateral differences in readings. In a group of 34 children with LS, we investigated the skin temperature and LD blood flow in unaffected skin at the same six sites.ResultsIn adults, physiological variability in LD blood flow and skin temperature between the two sides of the body was found to be greater than the uncertainty introduced into the measurements by (inter alia) limited intra- or inter-operator reproducibility. The cheek displayed the highest mean asymmetry in both skin temperature (0.5 degrees C) and LD blood flow (40%).ConclusionOur protocol combines IRT, LD and photography for LS assessment in children, and establishes a normal range of readings in line with other authors.

Poster Session 3. Scleroderma and related disordershancement affecting the distal radius as well as the proximal carpal row and proximal aspect of the hamate.The joint fluid subsequently yielded a pure growth of Pseudomonas aeruginosa.The patient was commenced on oral ciprofloxacin in accordance with sensitivity studies.He underwent 3 washouts of the left wrist within the first week of diagnosis due to the complex nature of his septic arthritis and slow response to conservative treatment.Conclusions: P. aeruginosa is a gram negative aerobe which is widely distributed with a predilection for moist environments.Bone and joint infections are well recognised but unusual and to the best of our knowledge no cases of p. aeruginosa wrist joint sepsis have been reported.The other point of interest is the atypical presentation of septic arthritis in this case.

This study assesses the accuracy of the volume flow measurement of the ATL HDI 3000 duplex ultrasound scanner using a model of the femoral arterial circulation. The beam profile of the transducer was measured, and used to identify regions of the beam where there may be poor insonation characteristics. The flow measurement accuracy was not found to be influenced by the vessel depth between 1.0 cm and 8.0 cm in a 0.7 cm diameter vessel. Overall accuracy was 3% ± 9%. Vessels in excess of 0.9 cm produced larger errors. In the model system, pulse rates between 60 bpm and 120 bpm had no significant effect on the measurement accuracy (p > 0.01). The results of this study suggest that accurate measurements of femoral arterial blood flow are possible. Further work will be required to assess the accuracy of the technique in vivo.