Application of Ultrasound in the Assessment of Plantar Fascia in Patients With Plantar Fasciitis: A Systematic Review

Abstract

Plantar fasciitis (PFS) is one of the most common causes of heel pain, estimated to affect 10% of the general population during their lifetime. Ultrasound (US) imaging technique is increasingly being used to assess plantar fascia (PF) thickness, monitor the effect of different interventions and guide therapeutic interventions in patients with PFS. The purpose of the present study was to systematically review previously published studies concerning the application of US in the assessment of PF in patients with PFS. A literature search was performed for the period 2000-2012 using the Science Direct, Scopus, PubMed, CINAHL, Medline, Embase and Springer databases. The key words used were: ultrasound, sonography, imaging techniques, ultrasonography, interventional ultrasonography, plantar fascia and plantar fasciitis. The literature search yielded 34 relevant studies. Sixteen studies evaluated the effect of different interventions on PF thickness in patients with PFS using US; 12 studies compared PF thickness between patients with and without PFS using US; 6 studies investigated the application of US as a guide for therapeutic intervention in patients with PFS. There were variations among studies in terms of methodology used. The results indicated that US can be considered a reliable imaging technique for assessing PF thickness, monitoring the effect of different interventions and guiding therapeutic interventions in patients with PFS.

Ultrasound-guided versus palpation-guided local corticosteroid injection therapy for treatment of plantar fasciitis

“…Findings that support the diagnosis of PF include increased proximal plantar fascia thickness and areas of hypoechogenicity ultrasonographically [5,6,13,25,26]. Plantar fascia thickening is a well established feature of PF.…”

Physiotherapy for plantar fasciitis: a UK-wide survey of current practice

“…24 A recent SLR on the use of ultrasound in the assessment of PF, found wide variations in methodology, however results indicated that ultrasound is accurate and reliable for assessing plantar fascia thickness, and for monitoring and guiding therapeutic interventions in patients with PF. 25 The primary aims of education, enhance self-management, improve function and decrease pain, were reported by over (206/257, 80%) of physiotherapists as "always" being an aim. All of these primary aims are recommended by NICE for PF.…”

Intra- and Inter-Rater Reliability of Ultrasound in Plantar Fascia Thickness Measurement

“…It is also used to measure the thickness of plantar fascia, to monitor the Copyright © 2018, Iranian Journal of Radiology. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited effect of different interventions and to help therapists to follow the effects of therapeutic interventions in patients with plantar fasciitis (5,(14)(15)(16)(17)(18). Additionally, ultrasonography has many other advantages to use, such as being accurate, reliable, non-invasive, and free of radiation.…”

“…Plantar fasciitis most commonly occurs up to 2 cm of the heel (6). Measurement stations used to determine plantar fascia thickness varies widely from its insertion at the calcaneal tubercle, until 3 cm distal from its insertion at the calcaneal tubercle (16). According to a study by McNally and Shetty (2010), plantar fasciitis occurs in the insertion, at the calcaneal tubercle, until 1 cm distal to this (6).…”

“…In most studies, ultrasound examination of plantar fasciitis is performed with the patient in prone position (16). However, one study showed that there is no statistical difference in ultrasound measurements of plantar fascia thickness between prone and supine positions.…”