WO1994013196A1

WO1994013196A1 - Apparatus for observation, collection and processing of data

Info

Publication number: WO1994013196A1
Application number: PCT/NO1993/000192
Authority: WO
Inventors: Bjørn FAGERLUND
Original assignee: Diatherm As
Priority date: 1992-12-17
Filing date: 1993-12-16
Publication date: 1994-06-23
Also published as: JPH08504340A; NO924906L; AU5721094A; NO924906D0

Abstract

Apparatus for the observation, collection and processing of data, in particular in connection with determining a status image of an organ, in particular a living organ, and more specifically a person who is awake, the apparatus comprising: a) means (21) for observation of a larger area of a person (20), in particular the whole person (20); b) means (22) for detecting one or several parameters which vary across the said larger area of the person (20) in the form of suitable data; c) means (23) for recording and/or storage of the said parameter data; d) means (25) for displaying the recorded and/or stored parameter data to provide one or several variable parameter computer status images which are specific for symptomatology in the relevant anatomical areas; e) means (26) for comparing the obtained variable parameter computer status image (201-204) with a normal image and/or norm image of a corresponding uninjured person; and f) means (27) for verification of the pain threshold of the person as related to the said status image.

Description

APPARATUS FOR OBSERVATION COLLECTION AND PROCESSING OF DATA

The scone of the invention

The present invention relates to apparatus for the obser¬ vation, collection and processing of data, in particular in connection with establishing an image of the condition of an organ, in particular a living organ, and more parti¬ cularly a person who is awake.

The background to the invention

Especially in connection with traffic accidents, injuries to the neck, so-called whiplash injuries, may occur. These types of injury generally do not leave any visible traces in the person afflicted, and there is great dissension among medical experts about the mechanisms of these in¬ juries and its implications, because it has so far only been possible to observe the pathophysiology, if any, of the injury, from interviews of the injured person by a doctor. This problem is especially dominant when the injured person approaches his insurance company to obtain compensation for the injury, and it is a not uncommon occurrence that the insurance companies refuse to accept the medical report they are given. As a result, the injured person will have to undergo further examinations, and the final decision as to the degree of a whiplash injury as stated, frequently becomes a battle between the traffic victim and in general two groups of medical experts with diverging opinions. One medical group subscribes to a diagnosis associated with a "pre-morbid character struc¬ ture" while the other group adheres to a diagnosis based on an "organic" injury.

Although some insurance companies have chosen to have the medical reports prepared by neurologists, that creates a problem, because whiplash injuries do not immediately re¬ present a neurological trauma. It has furthermore been suggested that examinations in connection with whiplash in¬ juries should also involve orthopaedists, psychiatrists, psychologists, anaesthesiologists, neurologists, neuro- physiologists, neurosurgeons etc., but not even this would make up for the lack of scientific apparatus which can in a scientifically satisfactory manner establish an image of the status which is specific in particular to whiplash injuries.

Prior art

Although the complex of problems associated with injuries to the back of the head or whiplash injuries has received ever increasing attention, both in terms of treatment and prophylactic, be it from medical quarters or insurance quarters, no apparatus or assembly of apparatus has pre¬ viously existed which could, associated with experience gained in this area so far, render a reliable and repro¬ ducible status image of the original region of the injury mechanism and its development from there.

In a medical context, the attention was first drawn to whiplash injuries in connection with the introduction and use of catapult seats in jet aircraft which resulted in compression fractures and injuries to the back of the head in the aviator. Later on, more "mundane" causes of such injuries have been given attention, and then especially in connection with traffic accidents. It should be under¬ stood, however, that injuries to the back of the head may also be caused in other contexts, e.g. in performing various sports disciplines, in nasty falls in general, or in any exaggerated abrupt change of the direction of the head relative to the rest of the body.

By comparing symptoms from individual to individual it has been possible to gather certain statistical material which is associated with whiplash injuries and the complications of the trauma. Moreover, by using local anaesthetic, it has been possible to retrace the pain which is related to a whiplash injury, while at the same time this technique has made it possible to retrace the pain to its outset, namely the region of the back of the head . The local anaesthetic technique is, however, complicated and time-consuming while at the same time not providing recordable and reproducible computer images of the status in the person concerned.

Furthermore, the use of infrared thermophotography is known, in particular in connection with observing thermal leaks in structural parts, buildings etc., and then in the area of industry. Medical infrared thermography is further known in rheumatology, fibromyalgia, psoriasis, and burns, but then linked to entirely local phenomena e.g. skin in- juries, entrapped nerves, or tenosynivitis.

Summary of the invention

The present invention is thus based on the task to describe apparatus of the initially specified kind, which can in an easy and reliable way give a scientifically reproducible status image reflecting various degrees of whiplash injuries.

This may be achieved according to the invention with the apparatus characterised in the attached patent claims.

The invention will be described in further detail below with reference to the attached drawings.

Brief mention of the drawings

Figures 1, 2 and 3 are general outlines illustrating how a whiplash injury may occur, especially in connection with traffic accidents, and in particular when hit from behind.

Figure 4 is a schematic outline showing an embodiment of apparatus according to the present invention. Figures 5, 6, 7 and 8 show an example of a section of a parameter-variable computer status image, made by using the apparatus according to the present invention.

Figures 9A, 9B, 9C, 9D, 9E, 9F, and 9G show a series of sections of another computer status image, procured by means of the apparatus according to the present invention, for a person with a highly advanced whiplash injury.

Figures 10A, 10B, IOC, 10D, 10E, 10F, 10G, and 10H show a series of sections of a parameter-variable computer status image for a normal image and/or a norm image of an un¬ injured person.

Detailed description of the embodiments

For the comprehension of the origin and further progression of a whiplash injury, it is important to know the actual injury mechanism, as this kind of injury may occur in all contexts where the head is subjected to abrupt directional changes relative to the rest, of the body. It shall more¬ over be understood that a whiplash injury may also occur in combination with head injuries, and that such injuries are not solely associated with traffic accidents.

As an example of how a whiplash injury may occur, reference is made to Figures 1, 2 and 3 which all relate to a traffic situation in which a driver 1 is exposed to a traffic accident by his car being hit from behind. Figure 1 shows the normal driving situation with the person 1 sitting in the driver's seat 2, with the seat portion 4 mainly hori¬ zontal, and with the seat back 3 mainly vertical, and usually leaning somewhat backward. When hit from behind, the kinetic energy will be transferred from the automobile behind to the vehicle concerned, entailing that the seat back 3, as shown in Figure 2, will impact with the back of the person 1, as shown at the arrow 6 in Figure 2. Because of the reclining design of the seat back 3, the first impact will occur in the hip/pelvis region as shown at the arrow 7 in Figure 2, whereupon the rest of the back will be flung backwards which will in turn entail that the head 8 for a very brief time interval will remain hanging forward in the automobile, until it is halted against the chest after an abnormally swift and exaggerated stretching of the region 9 of the back of the head. The head 8 will there¬ after be subjected to an accelerating movement backwards and upwards, as shown with the reference numeral 8' in

Figure 3, while simultaneously with this course of events, the body is being pushed upwards and backwards along the seat back 3, please see the arrows 7A and 7B. The outcome will thus be that 8' is flung backwards and past the body, and most frequently across the head-rest 10. The back of the head has thus performed a maximal deflection, not merely forwards but also backwards, after which the body will gradually attain the same speed as the car which has been hit, and the driver or the person l will thereafter slide back and down as usual into the seat 2.

It should be understood that this example of a whiplash injury is only intended to be illustrative, as the movement to which the body is subjected may be composed of movements forwards and backwards, as well as movements at an angle, and side-to-side movements, all depending on what the position is of the body at the time of collision. It all happens so quickly, however, that the person afflicted has no time to correct the bearing of his head to prevent the immediate harmful flinging movement of the head which also in many instances means a local collision between the skull and the cerebral substance with possible brain damage.

At the outset, a person's back and the back of his head are not prepared for tolerating such abrupt speed changes which frequently occur in modern, fast traffic. The spinal column of a person is intended to serve two main functions, namely stability and mobility and thus constitutes a highly sophisticated anatomical structure with 97 synovial and 23 synchondrotical joints. As a result of this anatomical construction, the back and the back of the head are very flexible, but also highly vulnerable to excess strains, in particular because the ability of many of the structures in the spine, especially the supporting tendons, to regenerate is very low, although marginal.

Shown in Figure 4 is an example of an apparatus for obser- vation, collection and processing of data, in particular in connection with determining an image of a condition in a person 20 who has been exposed to a whiplash injury for the purpose not only of determining the said image of the status as such but also in relation to a normal image and/or a norm image.

The example of an apparatus shown in Figure 4 comprises means 21 for observing a larger area of the person 20, in particular the whole person 20, and in a specific working example, such means may comprise one or several thermo- graphic cameras, depending on whether a two-dimensional or a three-dimensional condition report of the person 20 is desired.

Furthermore, the apparatus shown in Figure 4 comprises means for detecting one or several parameters which vary in the person 20, especially across a larger area of the person 20, and more specifically across the whole person as such, and these means of detection may for instance com- prise means 22 which may suitably be integrally connected to the said camera 2 in a suitable unit 24 to allow the parameters observed at the camera 21 to be detected in the form of suitable data, using the said detection means 22.

For a rational processing of these observed and detected data there may, together with the unit 24 shown in Figure 4, be means 23 built in for the recording and/or storage of the said parameter data, and in one example of an embodi- ment of the present invention, the means 23 may be a small computer which will by using suitable hardware or software be able to process the said data in a speedy and efficient manner, preferably in real time mode.

For the purpose of being able to visually monitor the ob¬ servation, collection and processing done of data of vari¬ able parameters, it is expedient that the apparatus shown in Figure 4 comprises means 25 for the display of the recorded and/or stored parameter data to provide with vari¬ able parameters, one or several computer status images, which is or are distinctive of whiplash injuries as mentioned above.

One such means of display may e.g. be a monitor screen which appropriately communicates with the previously mentioned computer 23 in such a way as to provide both live images and still images which reflect the special pattern characteristic of a whiplash injury.

Further shown in Figure 4 are means for comparing the variable-parameters computer status image obtained with a normal image and/or a norm image, and one such apparatus component 26 may e.g. be another computer comprising stored norm images and designed to receive the parameter-variable computer status images from the former computer 23, so that these images may be compared in preparing a basis related report on the status in the person 20.

Also shown in Figure 4 is a probe 27 which can in a suit¬ able manner be guided along the person 20 in contact with him, to feel the pain threshold of the person relative to the parameter-variable computer status image obtained from the computers 23 and 26, in order thus to have further con- firmation that a whiplash injury exists, and the degree to which it has progressed. The camera 2 may suitably be a camera to detect variations in the generation of energy within the said larger areas of the person 20 or the whole person, and appropriately this may be a camera which detects emitted energy in a suitable infrared range, for example in the wave range 2-20 μ.

Finally, shown in Figure 4 is a printer unit 28 which serves to print out the image observed on the monitor 25, or serves to print out the relevant status image compared with a norm image.

It is of importance that the apparatus according to Figure 4 and otherwise that the apparatus according to the present invention, is thus assembled and adjusted that if detection in the infrared range is used, the apparatus should be able to detect a core zone occurring in the region 201 at the back of the person's head, of particularly high energy- generation and thus high temperature, as well as branches of high temperature radiating from the core zone 201 and running along particular nerve paths or associated soft tissue, and then both from the back of the head 201 and to¬ wards the person's head 202, and from the back of the head 201 and downwards on the upper part 203 and lower part 204 of the person's body, as well as on the outsides of the person's arms 205, and also partly or completely down the person's thighs 206, optionally simultaneously with a scan of leg zones 207, 208 of particularly low temperature.

Shown in Figures 5, 6, 7, and 8 are still images from the monitor 25 and as will be seen from them its is expedient that the above mentioned areas of high temperature should represent temperatures of abt. 35.5° C or above. If colour monitors are used, the apparatus as such may be adjusted to represent the highest temperature of 35.5°C in a yellow or yellow-white colour scale while intermediate temperatures of abt. 30°C may be represented by a reddish colour scale, while at the same time a lowest temperature which may be abt. 19°C and below, may be represented by a blue and/or black colour scale. Otherwise, Figure 5 shows a frontal image of a person's head, Figure 6 shows the profile of the head region of a person, Figure 7 shows the midriff region of the person, while Figure 8 shows the person's legs. It has turned out, surprisingly, that the computerised status image shown here is altogether specific to a whiplash injury, i.e. a core zone of high temperature is present in the region of the back of the person's head, which is also reflected in the person's body language in that the said person adopts a posture with the head's centre of gravity pushed forward somewhat relative to the back column for the purpose of alleviating the pain at the back of his head.

This core zone represents initially the seat of the whiplash injury, and when the injury progresses, the pain will develop along the crest of the back of the head and forwards in the head which also entails a corresponding re¬ flection in the temperature increase, see Figures 5 and 6. The said change in the position of the head will lead to a changed posture of the upper back region which will in turn cause pains from tendons between the projections on the backbone and from the system of muscles among the ribs.

From Figures 5 and 6 it will also be seen that zones of pain occur around the eyes and towards the temple, the latter apparently being associated with an entirely special dysfunction adopted by patients in whiplash pain. This will thereupon spread into the upper extremities which are characterised by a substantially lower temperature. This is an expression of a sympatic dystrophia, caused by a possible sympathetic nerve injury in the back of the head.

The pain will also spread from the area at the back of the head and down along the back which will be seen from Figure 6, but also clearly from the series of images 9A-9G, in particular Figure 9C, 9D and 9E, and in some the pain also spreads from the hip crest forwards towards the groin, see in particular Figure 7. Furthermore, the pain may spread down along the outside of the thigh, see in particular Figure 8, and down to the knee, and after some time, past the knee and along the out¬ side of the calf and down towards the outer rim of the foot. It should, however, be pointed out again here that the apparatus here will scan for a particularly low tempe¬ rature simultaneously with the patient here describing his "pains" as a numbness of the cold legs and feet areas.

This surprising variation between over-temperated zones sensing a high degree of pain and severely under-temperated and numb regions in the same person means further confir¬ mation of parameter-variable computer status images which are specific to whiplash injuries.

For a comparison of this specific status image of a person with a typical whiplash injury, reference is made to Figures 10A-10H showing a corresponding series of images as in Figures 9A-9G, but taken here from a person not affected by whiplash injury. In other words, the images of Figures 10A-10H show an uninjured person who will appear on a thermographic monitor with a body of comparatively cool colours, the coldest one being black, in particular the tip of his nose and the outermost cartilage of the ears, as well as the extremities of considerably reduced tempera¬ ture, down towards abt. 19°C where the normal temperature lies in the colour scale blue to red, i.e. in the range of abt. 30°C. Innermost at the corners of the eyes by the tear ducts there is, however, a tiny spot of yellow-to- white which denotes a temperature closer to the core body temperature, and by photographing several of such uninjured persons it will be possible by means of straightforward computer technology to provide a suitable normal status image or norm image.

From Figures 5-8 it will be seen that it is also possible to observe the variation in parameters along a horizontal line which may be moved on the monitor screen according to where on the person this observation is being used. Relative to a vertical centerline it is then possible to obtain a symmetrical image of the distribution of tem¬ perature which in turn corresponds to the degree of symme- trical or asymmetrical development of the pattern of pain in the person. This symmetry or asymmetry can thus be additional confirmation of where in the region of the back of the head the injury originated, and in what manner the whiplash initiating the injury took place, i.e. either directly forward or directly backward, at an angle or side¬ ways, or with the position of the person's head being more or less twisted when the whiplash occurred.

It should be understood that the probe 27 shown in Figure 4 which serves to detect the person's level of pain, may also be represented by an assistant person who communicates interactively with the observed person and the other com¬ ponents or elements which are part of the apparatus.

If an assistant person or a medically skilled person attends the observation, he or she will be able to show as requested that the areas of pain coincide with the heated regions in the patient, since this may be done by the doctor applying light testing pressures with his fingers to these regions, and the patient will then express pain. Moreover, the doctor may show how unaffected soft tissue areas of the body are free from pain when touched in the same manner. The doctor may furthermore show the head injury at the back of the head and how it has spread in the body along nerve paths and encapsulating soft tissue as well as the muscular attachments involved.

Whether a probe 27 is used or an assisting person, e.g. a doctor or a therapist, to feel the level of pain in the person observed, experience has surprisingly shown that the person expresses distinct pain responses from even the slightest pressure against the heated zones reflecting whiplash injury, or patterns as mentioned above, detected by the apparatus described.

The observation of one person may thus be done as mentioned in connection with Figure 4, and together with the neces¬ sary print-outs from the observations, also the entire examination or the observation may be filmed with video camera so that there will be no need for the examination to be repeated unnecessarily for the persons or institutions whose task it is to evaluate the result of the observation.

By means of the apparatus according to the present inven¬ tion it is possible not only to determine the relevant status image in a person, but also by using suitable means to calculate the proportion represented by the core zone affected by the high temperature, and pertaining high-tem¬ perature branches therefrom, relative to a normal image or norm image.

Claims

P a t e n t C l a i m s

1. Apparatus for the observation, collection and processing of data, in particular in connection with determining a status image of an organ, in particular a living organ, and more specifically a person who is awake, c h a r a c t e r i s e d i n the apparatus comprising a) means (21) for observation of a larger area of a person (20) , in particular the whole person (20) , b) means (22) for detecting one or several parameters which vary across the said larger area of the person (20) in the form of suitable data, c) means (23) for recording and/or storage of the said parameter data, d) means (25) for displaying the recorded and/or stored parameter data to provide one or several variable parameter computer status images which are specific for symptomatology in the relevant anatomical areas, e) means (26) for comparing the obtained variable parameter computer status image (201-204) with a normal image and/or norm image of a corresponding uninjured person, and f) means (27) for verification of the pain threshold of the person as related to the said status image.

2. Apparatus as stated in claim l, c h a r a c t e r i s e d in that the detection means (22) are arranged for detection of variations in generation of energy within the said larger area of the person (20) or the whole person (20) , and that the said detection means (22) are arranged for detection of the emitted energy dependent radiation from the said person.

3. Apparatus as stated in claims l or 2, c h a r a c t e r i s e d in that the said detecting organs (22) are arranged for the detection of emitted energy in a suitable temperature-reflecting range, in particular the infrared range, for example in the wave range 2-20 μ.

4. Apparatus as stated in claim 1, c h a r a c t e r i s e d in that the said means (21, 27) scan a temperature-varying image (201-204) which is specified in particular for whiplash injuries, chronic back pain, headaches, migraine or fibromyalgia.

5. Apparatus as stated in one of the preceding claims, c h a r a c t e r i s e d in that the said means of detection for detecting emitted energy communicate with means (25, 26) to provide a variable parameter computer status image in the form of a two-dimensional or three- dimensional temperature-varying image of the observed person (20) , and that the said means (25, 26) communicate with additional means (21, 27) which scan a core zone appearing in the region (201) of the back of the person's head, of particularly high energy generation and thus high temperature, as well as high-temperature branches radiating from the core zone (201) proceeding along specific nerve paths or associated soft tissue both from the back of the head (201) and towards the person's head (202) , and from the back of the head (201) and down across the upper part (203) and the lower part (204) of the person's body, as well as partly or wholly down across the person's thighs (206) and legs (207), optionally simultaneously with scanning of leg zones (207, 208) of especially low temperature.

6. Apparatus as stated in one of the claims to 4, c h a r a c t e r i s e d in that the said means (21, 27) scan a temperature-varying image which comprises a sphere¬ like core zone of particularly high energy generation, in particular a zone in a person's back region, and more particularly a zone resembling a muscular knot.

7. Apparatus as stated in one of the claims 1 to 4 c h a r a c t e r i s e d in that the said means (21, 27) scan a temperature-varying image which comprises especially large anatomical expanses, preferably without marked core points.

8. Apparatus as stated in claims 5 to 7, c h a r a c t e r i s e d in that the scanner means are adjusted to a specifically high temperature which is abt. 35.5°C or above.

9. Apparatus as stated in claims 5 to 8, c h a r a c t e r i s e d in that the scanner means are adjusted to represent the highest temperature of abt. 35.5°C as a yellow or yellow-white colour scale, while intermediate temperature of abt. 30°C is represented as a reddish colour scale, and while the lowest temperature in the range of around 19°C is represented as a blue or black colour scale.

10. Apparatus as stated in one of the preceding claims, c h a r a c t e r i s e d in that the said observation means for observing a larger area of a person (20) or the whole person (20) comprise one or several video cameras sensitive to energy radiation, for two-dimensional and/or three-dimensional observation of the person (20) , that the detection means for detecting the said parameter or parameters varying with the person comprise a computer arranged in each camera or centrally, that the means for recording or storage of the said parameter data are incorporated into the said computers, and that the display means comprise a monitor screen to provide live and still computer status images, varying with the parameters, in two or more dimensions and/or one or several outlines.

11. Apparatus as stated in one of the preceding claims, c h a r a c t e r i s e d in that the means for comparing the obtained computer status image or images, varying with the parameters, comprise means for calculating the proportion of the core zone affected by the high temperature and pertaining high-temperature branches therefrom, relative to a normal image or norm image.

12. Apparatus as stated in one of the preceding claims, c h a r a c t e r i s e d in that the means for verification of the pain threshold of the person as related to the parameter-varying computer status image, consists of a probe (27) contacting with the person and in turn comprising organs for measuring the patient's pain threshold in response to the contact, or that the said means for verification of the person's pain threshold comprise an assistant person who communicates interactively with the observed person (20) and the other elements of which the apparatus is composed.

13. Application of a thermo-monitoring apparatus for per se known industrial use for the observation, collection and processing of data, in particular in connection with the determination of a temperature-dependent specific status image of persons with especially whiplash injuries.