Clinical Utility of Infrared Thermography in Pediatric Patients: A Systematic Review of Surgical and Nonsurgical Applications.

Introduction: Accurate and timely diagnosis in pediatric care is often challenging due to nonspecific clinical signs and the limited ability of young patients to communicate symptoms. Infrared thermography (IRT), a noncontact imaging modality that detects changes in skin surface temperature, has emerged as a promising tool for early detection of various clinical and surgical complications. Its utility in pediatric populations is particularly attractive given its safety, noninvasiveness, and ability to provide real-time thermal mapping. Objective: To systematically review and evaluate the clinical applications, diagnostic performance, and practical utility of IRT in pediatric patients across both surgical and nonsurgical settings. Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. A comprehensive literature search was performed across PubMed, Embase, and Web of Science for studies published between 1975 and 16 June 2025. Eligible studies included human subjects aged 0-18 years where IRT was used for diagnosis or monitoring in surgical or clinical contexts. Data were extracted on study design, population, clinical indication, type of IRT device, diagnostic outcomes, and limitations. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies 2 and Risk Of Bias In Non-randomized Studies of Interventions. Results: Forty-seven studies were included (5 surgical, 31 clinical, and 11 trauma/emergency). Diagnostic accuracy varied across domains, with burn depth assessment achieving up to 100% specificity, fracture detection sensitivity of 91%, and specificity of 89%, and inflammatory detection sensitivity between 92% and 96%. Diagnostic accuracy varied across domains, though most studies were small and heterogeneous. Conclusion: IRT appears to be a promising noninvasive adjunctive tool for selected pediatric clinical applications. However, the current evidence is limited by small sample sizes, heterogeneity of study designs, and variability in imaging protocols, underscoring the need for large, well-designed prospective studies before routine clinical adoption can be recommended.