Ultrasonographic examination of plantar fasciitis: a comparison of patient positions during examination

Ahn, Jae Hoon; Lee, Choong Woo; Park, Chanjoo; Kim, Yoon-Chung

doi:10.1186/s13047-016-0171-4

Cited by 12 publications

(16 citation statements)

References 18 publications

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“…MRI is the imaging modality of choice in confirming the diagnosis of plantar fasciitis. However, ultrasonography has the advantages of easy accessibility, lower cost, it is relatively fast, and has very good spatial resolution for superficial structures; hence, it is used increasingly in the diagnosis of plantar fasciitis [ 23 , 24 ]. There are few studies on the role of ultrasound elastography, which can detect initial changes in plantar fascia stiffness before the detection of findings on routine ultrasound [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of plantar fascia using high-resolution ultrasonography in clinically diagnosed cases of plantar fasciitis

Aggarwal¹,

Jirankali²,

Garg³

2020

Pol J Radiol

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The aim of this study was to assess the efficacy of high-resolution ultrasonography in the assessment of plantar fascia in individuals with heel pain, before and after treatment. Material and methods: This study was conducted from 2016 to 2019, during which time 44 clinically diagnosed patients of plantar fasciitis were compared to 50 normal volunteers. There were 25 males and 25 females in the control group and 42 females and two males in the study group. Thirty-eight patients had unilateral disease, and six patients had bilateral disease. The thickness of the plantar fascia was measured just anterior to its calcaneal attachment using ultrasonography. Body mass index (BMI) was also calculated in both groups. Results: The plantar fascia was 2-4 mm thick in the control group whereas it was > 4 mm thick in 48 heels in the study group. With cutoff of > 4 mm as diagnostic of plantar fasciitis, this study had a sensitivity of 96%, specificity of 100%, and accuracy of 98%. BMI was increased in 60% of female patients. All patients were treated with local infiltration of corticosteroid. In 37/42 patients (43 heels) who had improved clinically, the thickness of plantar fascia was reduced to < 4 mm when assessed after six weeks of corticosteroid injection. Conclusions: Diagnosis of plantar fasciitis can be easily verified by ultrasonography with plantar fascia thickness > 4 mm being suggestive of plantar fasciitis. Ultrasound can also be used to evaluate treatment response. Ultrasonography helps the clinician in confirming the diagnosis of plantar fasciitis and also in assessing the response to treatment.

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Section: Discussionmentioning

confidence: 99%

Evaluation of plantar fascia using high-resolution ultrasonography in clinically diagnosed cases of plantar fasciitis

Aggarwal¹,

Jirankali²,

Garg³

2020

Pol J Radiol

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“…To the best of our knowledge and as evoked in the Introduction, this study is the first of its kind. The pertinence of such study resides in the fact that (i) oral DK has shown better analgesic and anti-inflammatory effects compared to DS when they were administered orally; (ii) DS exists in (spray) gels (and patches) for topical application [ 29 ] and is commercialized, whereas we failed to find studies related to marketed DK gels; (iii) phonophoresis is commonly used in combination with DS gels for the treatment of musculoskeletal injuries [ 38 , 39 ], and it was proved more effective than DS alone [ 39 , 40 ], but no studies have evaluated phonophoresis in combination with diclofenac derivatives, such as DK.…”

Section: Resultsmentioning

confidence: 99%

“…Indeed, medication particles are pushed deep into the skin tissue by ultrasound waves. A resting membrane potential caused by DK relaxed muscles and phonophoresis increases the penetration of the drug into tissues and circulation, which in turn decreased pain and inflammation [ 37 , 38 , 39 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

Formulation and Evaluation of Diclofenac Potassium Gel in Sports Injuries with and without Phonophoresis

Bukhari¹,

Khan

Ishaq

et al. 2022

Gels

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Background: Pain remains a global public heath priority. Phonophoresis, also known as sonophoresis or ultrasonophoresis, is when an ultrasound is used to maximize the effects of a topical drug. Purpose: The objective of this study was to test, in patients injured in sports or accidents (N = 200), the efficacy of diclofenac potassium (DK) 6%, 4%, and 2% formulated gels with and without phonophoresis in comparison with market available standard diclofenac sodium (DS or DN) gel. Methods: The patients were enrolled after informed consent. By using the lottery method, 100 patients were randomly segregated into five groups without phonophoresis and repeated similarly with phonophoresis at a frequency of 0.8 MHz, an intensity of about 1.5 W/cm2, and at continuous mode (2:1). Group-1 was treated with 6% DK gel, group-2 was treated with 4% DK gel, group-3 was treated with 2% DK gel, group-4 was treated with 4% DS gel and group-5 was given control gel three to four times a week for 4 weeks. The patients were screened by using NPRS and WOMAC scales. They were assessed on the baseline, 4th session, 8th session, 12th session, and 16th session. Results: Significant dose-dependently relief was observed in NPRS (Numeric Pain Rating Scale) and the WOMAC (Western Ontario McMaster Osteo-Arthritis) index for pain in disability and stiffness for each group treated with DK gel compared to DS gel. Phonophoresis increased these benefits significantly when used after topical application of DK gel or DS gel, and the dose-dependent effects of DK gel plus phonophoresis were stronger than the dose-dependent effects of DS gel plus phonophoresis. The faster and profounder relief was due to phonophoresis, which allows more penetration of the DK gel into the skin as compared to the direct application of DK gel in acute, uncomplicated soft tissue injury, such as plantar fasciitis, bursitis stress injuries, and tendinitis. In addition, DK gel with phonophoresis was well tolerated. Thus, in this personalized clinical setting, according to the degree of inflammation or injured-induced pain, disability, and stiffness, DK gel 6% with phonophoresis appeared more effective and thus more recommendable than DS gel 6% alone or DS gel 6% combined to phonophoresis.

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“…Measurements of the vertical thickness of the plantar fascia were made from the anterior aspect of the inferior border of the calcaneus (figure 2). 7 The built-in ultrasound caliper tool was used to make the measurements. The plantar fascia was measured at the initial visit, the final visit, and at the cross-over visit for subjects in the control group.…”

Section: Pi = Principle Investigatormentioning

confidence: 99%

Lyftogt perineural injection therapy® as a primary treatment for plantar fasciitis: a randomized, controlled pilot with crossover

Conaway

O'Donnell

Pepe

et al. 2020

Scholar: Pilot and Validation Studies

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Background: Plantar fasciitis is a common condition that interferes with patient function and activity level. This study compared usual care to Lyftogt perineural injection therapy® as a primary treatment for plantar fasciitis. Methods: Subjects with foot pain associated with plantar fasciitis were recruited in to the study. They were randomized into the usual care protocol or treatment with Lyftogt perineural injection therapy®. Subjects in the injection group were injected weekly for 8 weeks. Five milliliters of 5% dextrose in water were injected perineural to the saphenous nerve at the adductor canal and the deep tibial nerve at the bifurcation of the gastrocnemius muscles of the affected side. Subjects who completed the 8 week usual care protocol, crossed over into the injection therapy arm. Subject assessed Roles and Maudsley Scores on a 1–4 scale, physician assessed pain with palpation on a 1–4 scale, and MSKUS measured plantar fasciitis thickness were tracked. Results: Complete information for 9 control and 9 intervention subjects was compiled. MSKUS measured plantar fasciitis thickness was significantly reduced in the intervention group (p = 0.019). Physician assessed pain with palpation was also significantly reduced for the compiled intervention group (p = 0.006). Conclusion: Lyftogt perineural injection therapy® may be a viable treatment option for plantar fasciitis.

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Ultrasonographic examination of plantar fasciitis: a comparison of patient positions during examination

Cited by 12 publications

References 18 publications

Evaluation of plantar fascia using high-resolution ultrasonography in clinically diagnosed cases of plantar fasciitis

Evaluation of plantar fascia using high-resolution ultrasonography in clinically diagnosed cases of plantar fasciitis

Formulation and Evaluation of Diclofenac Potassium Gel in Sports Injuries with and without Phonophoresis

Lyftogt perineural injection therapy® as a primary treatment for plantar fasciitis: a randomized, controlled pilot with crossover

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