Design Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared. Methods A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups ( P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group. Conclusion Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection. Levels of Evidence: Level II
Background/Aims One of the main aetiologies of patients' symptoms who have degenerative knee disease is pes anserine tendinitis or bursitis. Local corticosteroid injection is an effective treatment for chronic cases. The aim of this study was to compare the efficacy of an ultrasonography-guided corticsosteroid injection vs a landmark-based injection. Methods A total of 31 patients with clinical chronic (>3 months) pes anserine tendinitis bursitis, confirmed by ultrasonography, were randomised into two groups. One group received a corticosteroid injection (40 mg triamcinolone acetonide) with ultrasonographic guidance, and the other group received a corticosteroid injection without ultrasonographic guidance. Participants and the assessor were blind to the type of procedure. Participants were clinically assessed using the Western Ontario and McMaster University knee questionnaire before and 2 weeks after the injection and a visual analogue scale before, 2 and 12 weeks after the injection. Results There were significant decreases for both groups in the visual analogue scale at 2 weeks and 12 weeks after the injection, with a superior decline in the ultrasound-guided group (mean difference: 60.00, P<0.001 in ultrasound-guided group, and mean difference: 25.33, P<0.022 in the surface landmark-based group). The Western Ontario and McMaster University questionnaire scores also demonstrated significant improvement in both groups, with no preferential difference between groups (mean difference: 26.87, P<0.001 in the ultrasound-guided group, and mean difference: 22.20, P<0.001 in the surface landmark-based group). Conclusions Steroid injection is an effective treatment to manage chronic pes anserine bursitis, and ultrasonography guidance may further improve clinical outcomes.
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