Elsevier

The Journal of Foot and Ankle Surgery

Volume 46, Issue 6, November–December 2007, Pages 442-446
The Journal of Foot and Ankle Surgery

Original research
Ultrasonographic Evaluation in Plantar Fasciitis

https://doi.org/10.1053/j.jfas.2007.08.006Get rights and content

The heels of 23 patients who were diagnosed with unilateral/bilateral plantar fasciitis were evaluated via ultrasonography and compared with their asymptomatic feet and a control group of 23 people. Plantar fascial thickness, echogenity, and heel pad thickness were evaluated, and the results were statistically analyzed. For symptomatic feet, increased thickness of the fascia and reduced echogenity were constant ultrasonographic findings (mean, 4.79 mm for symptomatic feet; 2.17 mm for control group, P < .05). No significant difference was found between heel pads of the diseased and healthy feet (mean, 12.96 mm for symptomatic feet; 13.10 mm for control group; P > .05). Ultrasonography seems to be a valuable, noninvasive diagnostic tool for the evaluation of plantar fasciitis.

Section snippets

Material and Methods

Twenty-three patients (group 1) with pain on the anteromedial part of the heel diagnosed as plantar fasciitis were selected, and US examinations were performed to evaluate the plantar fascia. In addition, a control group of 23 people (group 2) with asymptomatic feet was set up to compare the findings of the symptomatic group (Table 2). Proximal plantar fascia and heel pad were assessed with a 7.5 to 9 MHz linear array ultrasound transducer (Sonoline Sienna, Siemens, Berlin, Germany). The

Results

In group 1, the right foot was symptomatic in 8 patients, the left foot was symptomatic in 10 patients, and both feet were affected in 5 patients (right, 34.8%; left, 43.5%; affected bilaterally, 21.7%).

Ultrasonographic evaluation clearly demonstrated that on symptomatic feet, thickness of the plantar fascia was greatly increased and the echogenity was reduced compared with the nonsymptomatic feet of the same group (Table 3) and the controls (Table 4) as reported in the literature (14, 17, 18,

Discussion

Plantar fasciitis, the most common cause of heel pain, is a degenerative process of the plantar fascia caused by excessive wear to the plantar fascia of the foot. In the presence of aggravating factors, the repetitive movement of walking or running can cause micro tears in the plantar fascia. Being flat footed, having a high arch, or even having an abnormal pattern of walking can adversely affect the plantar fascia, putting extra stress on the plantar fascia. Plantar fasciitis tends to be more

Conclusion

Ultrasound seems to be a very valuable diagnostic tool for detecting plantar fascial thickness and documenting inflammatory findings. In patients with plantar fasciitis, ultrasound may detect relatively small differences in plantar fascial thickness even in clinically undetected cases. US assessment is relatively quick, cheap, and widely available. The greater spatial resolution of US for superficial structures provides advantages over MRI in the assessment of patients with plantar fasciitis.

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  • Cited by (0)

    1

    Radiologist, Department of Radiology, Hand and Microsurgery & Orthopedics and Traumatology Hospital, Izmir, Turkey.

    2

    Orthopaedic Surgeon, Department of Orthopaedics and Traumatology, Hand and Microsurgery & Orthopedics and Traumatology Hospital, Izmir, Turkey.

    3

    Orthopaedic Surgeon, Department of Orthopaedics and Traumatology, Buca Seyfi Demirsoy State Hospital, Izmir, Turkey.

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