No abstract

Background: plantar fasciitis is the most common cause of inferior heel pain. Sonography should be the initial imaging modality for straight forward confirmation of clinically suspected plantar fasciitis. MRI may be reserved for cases where a more diagnosis of plantar fasciitis is not satisfactory to explain the clinical presentation and when complex pathology is suspected. the aim of the study is to assess the role of MRI in assessment of plantar fasciitis. Methods: This study was carried out at Radio diagnosis Department, Zagazig University Hospitals; the study was carried on 18 patients and 18 asymptomatic volunteers were used as a control group. Ultrasonography and MRI were done to all patients. Results: The plantar fascia was thickened in symptomatic feet. The thickness of the plantar fascia in symptomatic feet was (2.9 -8.4 mm; 6.01± 1.4) measured by ultrasound which was significantly thicker than in the control group (1.90 -3.70 mm; 3.09±0.8), P < 0.05. Other sonographic signs used for the diagnosis of plantar fasciitis in the study were compared to MRI findings. The diagnostic accuracy was 83.3 for plantar fascia thickening, 83.3% for intra-fascial abnormal signal, 77.8% for soft tissue edema, and the lowest diagnostic accuracy of ultrasound was in detection of associated calcaneal spur (38.9%). The findings were tabulated and discussed in relation to other literature. Conclusion: sonographic diagnosis of plantar fasciitis is a useful tool with an acceptable diagnostic accuracy comparable to MRI. Sonography should be the initial imaging modality. MRI may be reserved when complex pathology is suspected.

Background To assess the subclinical cardiovascular affection in juvenile idiopathic arthritis (JIA) Egyptian patient subtypes using Doppler ultrasonography (US) for carotid and femoral arteries and detecting their predictors Results Forty percent of the patients were polyarticular type, while 40% were systemic onset and 20% were oligoarticular. There was a statistically significant difference between JIA and controls in all parameters of subclinical atherosclerosis by ultrasonography except right external carotid velocity and (right and left) femoral velocity. There was also a highly significant increase in intima-media thickness (IMT) in systemic onset type of JIA. There was a statistically positive correlation between increased internal carotid velocity (right and left) and high erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), lipid profile, and disease activity. High disease activity and lipid profile were valid predictors of subclinical atherosclerotic cardiovascular affection in JIA. Conclusion Increased cardiovascular risks and subclinical atherosclerosis in patients with JIA especially systemic onset type may be due to higher prevalence of multiple risk factors in these patients. Doppler ultrasonography is a simple, non-invasive technique which can be used to detect subclinical atherosclerosis in JIA. Control of disease activity by treat to target strategy and proper diet control should be applied for every patient with JIA especially those with systemic onset type for future prevention of cardiovascular disease.