Ultrasound Diagnosis of Plantar Fasciitis

Wall, Janet Rae; Harkness, Margo Amy; Crawford, Alan

doi:10.1177/107110079301400807

Cited by 103 publications

(74 citation statements)

References 9 publications

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“…Although level of physical activity was not measured, it is unlikely that plantar fasciitis, a common condition among athletes, is the cause of fascia thickness. Fasciitis is associated with heel pain, and its ultrasonographic changes are limited to the proximal insertion of the aponeurosis (25).…”

Section: Discussionmentioning

confidence: 99%

Association Between p.Leu54Met Polymorphism at the Paraoxonase-1 Gene and Plantar Fascia Thickness in Young Subjects With Type 1 Diabetes

et al. 2008

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OBJECTIVE -In type 1 diabetes, plantar fascia, a collagen-rich tissue, is susceptible to glycation and oxidation. Paraoxonase-1 (PON1) is an HDL-bound antioxidant enzyme. PON1 polymorphisms have been associated with susceptibility to macro-and microvascular complications. We investigated the relationship between plantar fascia thickness (PFT) and PON1 gene variants, p.Leu54Met, p.Gln192Arg, and c.-107CϾT, in type 1 diabetes. RESEARCH DESIGN AND METHODS-This was a cross-sectional study of 331 adolescents with type 1 diabetes (162 male and 169 female). PFT was assessed by ultrasound, PON1 was assessed by genotyping with PCR and restriction fragment-length polymorphism, and serum PON1 activity was assessed by rates of hydrolysis of paraoxon and phenylacetate.RESULTS -Median (interquartile range) age was 15.4 (13.5-17.3) years, and diabetes duration was 7.6 (4.9 -10.6) years. The distribution of p.Leu54Met genotypes was LL 135 (40.8%), ML 149 (45%), and MM 47 (14.2%). PFT was abnormal (Ͼ1.7 mm) in 159 adolescents (48%). In multivariate analysis, predictors of abnormal PFT were ML/LL versus MM p. CONCLUSIONS -Thickening of the plantar aponeurosis occurs predominantly in overweight and male adolescents with type 1 diabetes. The MM genotype at PON1 p.Leu54Met is associated with a reduced risk of abnormal PFT.

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Section: Discussionmentioning

confidence: 99%

Association Between p.Leu54Met Polymorphism at the Paraoxonase-1 Gene and Plantar Fascia Thickness in Young Subjects With Type 1 Diabetes

et al. 2008

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“…1,16,31 The average thickness of the plantar fascia in healthy individuals is between 2.2 and 3.6 mm. 13,30 In patients with plantar fasciitis, it ranges from 4.6 to 6.1 mm. 1,15,16,19 In general, individuals with a plantar fascia thicker than 4 mm are considered to have plantar fasciitis.…”

Section: Discussionmentioning

confidence: 99%

Association Between Plantar Fascia Vascularity and Morphology and Foot Dysfunction in Individuals With Chronic Plantar Fasciitis

Chen¹,

Ho²,

Ying³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

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Plantar fasciitis is one of the most common painful foot con ditions. It affects both active and sedentary adults, with a peak incidence in those between 40 and 60 years of age. 8,20 Impaired vascularity with subsequent metabolic disturbance has been proposed as one of its causes.11,31 A moderate to marked increase in vascularity in the proximal plantar fascia has been observed in patients with plantar fasciitis. 7,31 This increase is typical in those who have had plantar fasciitis for less than 12 months, and has been associated with greater intensity of pain.31 Similar vascularization has been observed in patients with Achilles, 23,36 patellar, 9 and rotator cuff tendinopathy. 18 The intensity of pain with chronic tendinopathy has also been found to be greater in patients with tendon vascularization compared to those without. 9,10,38 Alfredson 2 proposed that vascularization in diseased tendons is one of the potential mediators of pain in tendinopathy, nerve ingrowth associated with new vessels being the cause of pain reported by patients.Higher tendon vascularity has also been reported to be associated with greater dysfunction in patients with patellar 9 and Achilles tendinopathy. T T METHODS:Thirty-eight patients with chronic unilateral plantar fasciitis and 21 controls participated in this study. Proximal plantar fascia vascularization and thickness were assessed using ultrasound imaging, and pain and foot dysfunction were quantified with a visual analog scale and the Chinese version of the Foot Function Index, respectively. Paired t tests were used to assess the side-to-side differences in fascia thickness and vascularity index (VI) in the control and patient groups, and an unpaired t test was used to make comparisons with the patient group. Multiple regression analysis was performed to identify whether the VI and fascia thickness were associated with pain and foot dysfunction. T T RESULTS:There were significantly higher VI (mean  SD, 2.4%  1.4%) and fascia thickness (5.0  1.3 mm) values in the affected feet when compared with the unaffected feet in the patient group (VI, 1.4%  0.5%; fascia thickness, 3.3  0.7 mm) and with the dominant side of the controls (VI, 1.6%  0.4%; fascia thickness, 2.9  0.6 mm). After accounting for age, gender, body mass index, and duration of symptoms, the VI explained 13% and 33% of the variance in pain scores measured with a visual analog scale and the pain subscale of the Foot Function Index, respectively; the VI and fascia thickness explained 42% of the variance in the Foot Function Index. T T CONCLUSION: Individuals with unilateralchronic plantar fasciitis demonstrated significantly greater vascularity and thickened fascia on the affected side compared to the unaffected side and also to healthy controls. Fascia vascularity was associated independently with self-perceived pain, and both fascia vascularity and thickness were associated with foot dysfunction in patients with chronic plantar fasciitis. Public trials registry: Current Controlled Trials, ISRCTN49594569. J...

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“…[12][13][14][15] The plantar aponeurosis, similar to tendons elsewhere, is shown sonographically as a homogeneous echogenic band with internal linear interfaces on longitudinal sections. 16 Sonography has also the advantages of being noninvasive, well tolerated by patients, and inexpensive, and it provides excellent spatial resolution for superficial structures. Previous studies reported that mechanical stress and inflammation result in tendon thickening, with hypoechoic areas within the plantar fascia 17 and, occasionally, peritendon fluid collection, 18 but these studies were done in a limited number of patients.…”

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confidence: 99%

Clinical Utility of Sonography in Diagnosing Plantar Fasciitis

Sabir

Demirlenk

Yagci

et al. 2005

Journal of Ultrasound in Medicine

155

131

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Objective. The purpose of this study was to investigate the efficacy of sonography in the detection of plantar fasciitis (PF) compared with magnetic resonance imaging (MRI) findings in subjects with inferior heel pain. Methods. Seventy-seven patients with unilateral (n = 9) and bilateral (n = 68) heel pain were studied. Seventy-seven age-and sex-matched asymptomatic subjects served as a control group. Magnetic resonance imaging was used to establish a diagnosis of PF with sagittal T1-weighted, T2-weighted, and short tau inversion recovery sequences. The sonographic appearances of PF were compared with MRI findings. Plantar fascia and heel pad thickness were also measured on both imaging modalities. Results. Compared with MRI, sonography showed 80% sensitivity and 88.5% specificity in assessing PF. A strong correlation was found between plantar fascia and fat pad thickness measurements done by sonography (P < .001; r = 0.854) and MRI (P < .001; r = 0.798). Compared with the asymptomatic volunteers, patients with PF had significant increases in plantar fascia and heel pad thicknesses, weight, and body mass index (P = .0001). Heel pad thickness was also significantly increased with pain duration (P = .021). Conclusions. Although MRI is the modality of choice in the morphologic assessment of different plantar fascia lesions, sonography can also serve as an effective tool and may substitute MRI in the diagnosis of PF.

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Ultrasound Diagnosis of Plantar Fasciitis

Cited by 103 publications

References 9 publications

Association Between p.Leu54Met Polymorphism at the Paraoxonase-1 Gene and Plantar Fascia Thickness in Young Subjects With Type 1 Diabetes

Association Between p.Leu54Met Polymorphism at the Paraoxonase-1 Gene and Plantar Fascia Thickness in Young Subjects With Type 1 Diabetes

Association Between Plantar Fascia Vascularity and Morphology and Foot Dysfunction in Individuals With Chronic Plantar Fasciitis

Clinical Utility of Sonography in Diagnosing Plantar Fasciitis

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