Ultrasound Evaluation of Plantar Fasciitis
Ola Mohamed Ali Hassan;
Abstract
The plantar fascia is the major shock absorber and support for the longitudinal arch of the foot. Upon heel strike, when the fascia becomes stretched, it flattens the longitudinal arch allowing the foot to accommodate to irregularities in the walking surface as well as absorbing shock. In the presence of aggravating factors that lead to continuous stress on the plantar fascia microtears occur with a subsequent inflammatory response (Singh et al, 1997). Predisposing factors include anatomical (foot deformities), biomechanical (e.g. obesity and tight Achilles tendon), and environmental (e.g. sports and shoe wear) factors.
Plantar fasciitis is the most common cause of heel pain. The typical presentation is pain during the first few steps upon rising in the morning or after a period of rest (Tsai et al, 2000\ Tsai et al, 20002 . A pathognomonic feature is tenderness at the insertion site of the plantar
fascia on the medial tubercle of the calcaneus (Leach et al, 1986; DeMaio et al, 1993).
The appropriate diagnosis can generally be made on a clinical basis. However, some patients may not have the typical features or may be refractory to the initial conservative treatment and confirmation of the diagnosis may be needed (Cardinal et al, 1996).
Plain radiographs may show a calcaneal spur but this is of no value because it can be found in asymptomatic heels (Kamel and Kotob, 2000). Bone scintigraphy may show an uptake in the calcaneus but this is not specific (Intenzo et al, 1991; Kane et al, 1998). MRl can diagnose plantar fasciitis and exclude other causes of heel pain (Berkowitz et al, 1991); however it is expensive and not always available.
Real-time high-resolution US is an ideal diagnostic imaging modality of choice for evaluation of plantar fasciitis because it is cheap, non-invasive, non-ionizing, available, quick and easy to perform, allows direct correlation with the opposite side, dynamic, offers high spatial resolution, and allows confirmation of the diagnosis and can therefore be used as a bed-side imaging modality and for serial follow-ups.
The purpose of this study was to evaluate the plantar fascia in the normal and the diseased states in patients presenting with clinical plantar fasciitis using high-resolution US.
Plantar fasciitis is the most common cause of heel pain. The typical presentation is pain during the first few steps upon rising in the morning or after a period of rest (Tsai et al, 2000\ Tsai et al, 20002 . A pathognomonic feature is tenderness at the insertion site of the plantar
fascia on the medial tubercle of the calcaneus (Leach et al, 1986; DeMaio et al, 1993).
The appropriate diagnosis can generally be made on a clinical basis. However, some patients may not have the typical features or may be refractory to the initial conservative treatment and confirmation of the diagnosis may be needed (Cardinal et al, 1996).
Plain radiographs may show a calcaneal spur but this is of no value because it can be found in asymptomatic heels (Kamel and Kotob, 2000). Bone scintigraphy may show an uptake in the calcaneus but this is not specific (Intenzo et al, 1991; Kane et al, 1998). MRl can diagnose plantar fasciitis and exclude other causes of heel pain (Berkowitz et al, 1991); however it is expensive and not always available.
Real-time high-resolution US is an ideal diagnostic imaging modality of choice for evaluation of plantar fasciitis because it is cheap, non-invasive, non-ionizing, available, quick and easy to perform, allows direct correlation with the opposite side, dynamic, offers high spatial resolution, and allows confirmation of the diagnosis and can therefore be used as a bed-side imaging modality and for serial follow-ups.
The purpose of this study was to evaluate the plantar fascia in the normal and the diseased states in patients presenting with clinical plantar fasciitis using high-resolution US.
Other data
| Title | Ultrasound Evaluation of Plantar Fasciitis | Other Titles | تقييم التهاب اللفافة الأخمصية بالموجات فوق الصوتية | Authors | Ola Mohamed Ali Hassan | Issue Date | 2002 |
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