Detection of Normal Plantar Fascia Thickness in Adults via the Ultrasonographic Method

Plantar fascia (PF) disorders commonly cause heel pain and disability in the general population. Imaging is often required to confirm diagnosis. This review article aims to provide simple and systematic guidelines for imaging assessment of PF disease, focussing on key findings detectable on plain radiography, ultrasound and magnetic resonance imaging (MRI). Sonographic characteristics of plantar fasciitis include PF thickening, loss of fibrillar structure, perifascial collections, calcifications and hyperaemia on Doppler imaging. Thickening and signal changes in the PF as well as oedema of adjacent soft tissues and bone marrow can be assessed on MRI. Radiographic findings of plantar fasciitis include PF thickening, cortical irregularities and abnormalities in the fat pad located deep below the PF. Plantar fibromatosis appears as well-demarcated, nodular thickenings that are iso-hypoechoic on ultrasound and show low-signal intensity on MRI. PF tears present with partial or complete fibre interruption on both ultrasound and MRI. Imaging description of further PF disorders, including xanthoma, diabetic fascial disease, foreign-body reactions and plantar infections, is detailed in the main text. Ultrasound and MRI should be considered as first- and second-line modalities for assessment of PF disorders, respectively. Indirect findings of PF disease can be ruled out on plain radiography. Teaching Points • PF disorders commonly cause heel pain and disability in the general population.• Imaging is often required to confirm diagnosis or reveal concomitant injuries.• Ultrasound and MRI respectively represent the first- and second-line modalities for diagnosis.• Indirect findings of PF disease can be ruled out on plain radiography.

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“…2 and 4) [16, 47–57]. Hyperaemia is a well-known feature of tendinopathy due to neurovascular growth and may contribute to pain.…”

Section: Ultrasoundmentioning

confidence: 99%

Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging

et al. 2016

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“…Normal plantar fascia thickness measured at the calcaneus is 4mm. 12 In patients with plantar fasciitis, the plantar fascia becomes thicker although the mechanism for this process is unknown. Studies show correlation between pain and increased thickness.…”

Section: Discussionmentioning

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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“…Visual analog scale & Roles and Maudsley scale: The orthopedic pain scale includes a simple 10 point visual analog scale (VAS) which ranges from a scale of either one to 10 or one to 100 (Figure 2a) [6]. This score is often used in many studies in aiding clinician’s interpretation of pain.…”

Section: Methodsmentioning

confidence: 99%

“…Fascia thickness: Heel pain is a common complaint and fascia thickness is one of the components used in the diagnosis of plantar fasciitis (Abul, et.al., 2015) [6]. It is noted that mean thickness of the plantar fascia measured by ultrasound is 0.3 mm in symptomatic heels as compared with 0.2 mm in asymptomatic heels.…”

Section: Methodsmentioning

confidence: 99%

Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis

Assad

Ahmad

Kiani

et al. 2016

Cureus

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We assessed the effectiveness of the different treatments for plantar fasciitis (PF) based on the changes in functional outcomes. A systematic literature search was carried out and studies from 2010 to 2016 were included in this review. The databases from Google Scholar, PubMed and Cochrane were used for the various treatment modalities of plantar fasciitis. The objectives measured included visual analog scale (VAS), Roles and Maudsley scale, foot function index (FFI), plantar fascia thickness and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot scale as the tools to predict the improvement in symptoms of pain and discomfort. Eight randomized controlled trails that met the selection criteria were included in this review. Extracorporeal shock wave lithotripsy (ESWL) with botulinum toxin type A, corticosteroid injections, autologous whole blood and plasma treatment, novel treatments like cryopreserved human amniotic membrane, effect of placebo, platelet rich plasma injections and corticosteroid injections, physiotherapy and high strength training were analyzed. All the treatment modalities applied did lead to the reduction in pain scores, but for long term management autologous condition plasma and platelet rich plasma are the preferred treatment options. Impact of physiotherapy and high strength training is equivalent to corticosteroid injections and hence is suited for patients avoiding invasive forms of treatment.

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Detection of Normal Plantar Fascia Thickness in Adults via the Ultrasonographic Method

Abstract: The plantar fascia thickness of adults without heel pain was measured to be less than 4 mm in most participants (~92%). There was no statistically significant difference between the thickness of the right and left foot plantar fascia.

Cited by 42 publications

References 19 publications

Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging

Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging

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

Novel and Conservative Approaches Towards Effective Management of Plantar Fasciitis

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