From:  Standardizing infrared thermography for occupational applications: an integrative narrative review of protocol quality, thermal metrics, and multimodal integration in work-related musculoskeletal disorders

 Clinical synthesis of modality roles when IRT is used as a functional marker in WMSD-oriented assessments (corpus-derived from the master data extraction spreadsheet; n = 247).

ModalityClinical “signal” captured (as recorded in outcomes_measures/comparator_reference)Typical clinical targets in the corpus (body region/condition_wmsd)How it is used with IRT in the corpus (comparator_reference/multimodal_components)Practical constraints and failure modes most commonly reported (limitations_bias_notes/protocol_key_points)
IRTSurface thermal metrics (absolute temperature; side-to-side asymmetry; ΔT/change/gradients; hot/cold patterning; rewarming/kinetic metrics when dynamic protocols are used)Upper limb (hand/wrist/forearm), lower back, knee, shoulder; occupationally framed symptom/risk contexts and mixed clinical MSK conditions (including neuropathic/vascular phenotypes in some subdomains)Primary functional layer; used as baseline + post-task/provocation + recovery mapping; frequently paired with patient-reported measures and, less often, with objective neuromuscular or imaging comparatorsHigh sensitivity to environment/protocol; incomplete protocol reporting; ROI/operator dependence; small samples/pilot designs; cross-sectional or short follow-up commonly noted
MSK ultrasound (with and without Doppler)Structural/soft-tissue and (when Doppler is present) perfusion-adjacent signals explicitly described as “ultrasound/sonography” and “Doppler/PD”Joints and peripheral segments (e.g., hand/wrist/fingers; foot; elbow), with recurring rheumatologic/degenerative and regional pain contexts in the corpusUsed as anatomical/structural comparator or complementary component in multimodal designs; typically deployed to contextualize IRT patterns with segment-level structural informationOperator dependence and ROI localization; heterogeneity of acquisition/reporting; limited direct workplace deployment in the corpus; protocol/environment sensitivity still reported in multimodal subsets
MRIDeep structural imaging explicitly described as MRI/magnetic resonanceRegional MSK pain syndromes, degenerative spinal contexts, and injury-related contexts in the corpus; multiple anatomical regions representedUsed as a structural comparator in multimodal/secondary synthesis contexts (i.e., to anchor structural interpretation when IRT is used functionally)Not interchangeable with IRT (different signal domain); limited occupational/workplace deployment in the corpus; frequent reliance on secondary synthesis designs; “specificity/gold standard” concerns occasionally noted
EMG/NCS (electrodiagnostics)Neuromuscular activation and peripheral nerve function explicitly described as EMG and/or NCSUpper-limb neuropathic/compressive phenotypes dominate (hand/wrist/fingers; CTS and other compressive neuropathies appear repeatedly in condition_wmsd)Used to provide an objective functional comparator for neuromuscular/nerve involvement when IRT is used as a surface-functional marker; occasionally embedded as a multimodal layer in diagnostic/assessment workflowsOperator/placement dependence; protocol sensitivity; small samples; heterogeneity of thresholds and reference standards; limited workplace implementation in the corpus (mostly clinical/lab or secondary synthesis)
DYNA
Strength testing
Force/strength endpoints explicitly described as dynamometry, grip strength, torque/isokinetic testingFrequently linked to functional capacity contexts (upper limb/shoulder; low back in some designs; healthy/task paradigms also present)Used as objective functional output alongside IRT (e.g., workload/fatigue/provocation paradigms) to triangulate functional impactSmall sample/pilot designs; variability in task standardization; protocol sensitivity; limited direct occupational/workplace deployment in the corpus
PROs
VAS and questionnaires
Patient-reported pain/function metrics explicitly described as VAS and/or questionnaires/scalesBroad across ROIs; recurrent in upper limb, knee, shoulder, and exercise/overuse-type paradigms; includes occupationally relevant symptom/function captureMost common complementary layer paired with IRT; used to align functional thermal patterns with symptom burden and perceived functionInstrument heterogeneity; cross-sectional designs; limited uniformity in timing relative to IRT acquisition; reporting variability in multimodal subsets

IRT: infrared thermography; MSK: musculoskeletal; MRI: magnetic resonance imaging; EMG: electromyography; NCS: nerve conduction studies; DYNA: dynamometry/strength testing; PROs: patient-reported outcomes; VAS: visual analog scale; ROIs: regions of interest; ΔT: temperature difference; PD: power Doppler.