Diagnostic imaging for chronic plantar heel pain: a systematic review and meta‐analysis

McMillan, Andrew; Landorf, Karl B; Barrett, Joanna; Menz, Hylton B.; Bird, Adam R

doi:10.1186/1757-1146-4-s1-p40

Cited by 35 publications

(46 citation statements)

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“…The findings from this study suggest that loss of plantar fascia elasticity may be an adjunct diagnostic criterion for plantar fasciitis on B-mode sonography, especially in patients with normal plantar fascial morphology. Besides plantar fascial thickening [9], other frequently reported imaging characteristics of plantar fasciitis include hypoechoic changes on B-mode sonography [10,19] and abnormal high intrasubstance signal intensity on T2-weighted and short tau inversion-recovery (STIR) MRI [20,21]. Such changes in echogenicity and signal intensity may correspond to histopathologic changes such as collagen degeneration and necrosis, angiofibroblastic hyperplasia, chondroid metaplasia, and matrix calcification [22].…”

Section: Discussionmentioning

confidence: 99%

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Plantar fascia softening in plantar fasciitis with normal B-mode sonography

Chen

Wang

2015

Skeletal Radiol

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Section: Discussionmentioning

confidence: 99%

“…The typical sonographic finding is thickening and reduced echogenicity of the plantar fascia [9]. However, not all patients exhibit such morphologic changes [4,10].…”

Section: Introductionmentioning

confidence: 99%

Plantar fascia softening in plantar fasciitis with normal B-mode sonography

Chen

Wang

2015

Skeletal Radiol

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“…This lack of clarification may be due to the high prevalence of subcalcaneal spurs in the asymptomatic population [15]. However, a comparison of asymptomatic and symptomatic heel spur groups shows a strong association between chronic heel pain and the presence of subcalcaneal spurs [7]. Researchers have also found that variations in spur length (longer spurs may be more symptomatic) and concurrent fat pad abnormalities may significantly influence the occurrence of pain [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…For soft tissue pathologies, such as plantar fasiit, ultrasonography and magnetic resonance imaging (MRI) are used, for osseous pathologies like calcaneal spur, plain film X-rays are used [7]. Despite the common use of these imaging methods, they offer limited benefits.…”

Section: Introductionmentioning

confidence: 99%

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Effects of extracorporal shock wave therapy on symptomatic heel spurs: a correlation between clinical outcome and radiologic changes

Yalçın

Akça²,

Selçuk

et al. 2010

Rheumatol Int

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Plantar heel pain, a chronic and disabling foot alignment, occurs in the adult population. Extracorporal shock wave therapy (ESWT) offers a nonsurgical option in addition to stretching exercises, heel cups, NSAI, and corticosteroid injections. This study aimed to investigate the effects of ESWT on calcaneal bone spurs and the correlation between clinical outcomes and radiologic changes. The study involved 108 patients with heel pain and radiologically diagnosed heel spurs. All patients underwent ESWT once a week for 5 weeks at the clinic. Each patient received 2,000 impulses of shock waves, starting with 0.05 mJ/mm2 (1.8 bar) and increasing to 0.4 mJ/mm2 (4.0 bar). Standard radiographies of the affected heels were obtained before and after the therapy. Clinical results demonstrated excellent (no pain) in 66.7% of the cases, good (50% of pain reduced) in 15.7% of the cases, and unsatisfactory (no reduction in pain) in 17.6%. After five ESWT treatments, no patients who received shock wave applications had significant spur reductions, but 19 patients (17.6%) had a decrease in the angle of the spur, 23 patients (21.3%) had a decrease in the dimensions of the spur, and one patient had a broken spur. Therefore, results showed no correlation between clinical outcome and radiologic changes. The present study supports the finding that even with no radiologic change after ESWT therapy, the therapy produces significant effects in reducing patients' complaints about heel spurs.

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Association of Calcaneal Bone Marrow Lesions and Plantar Fascia Imaging Biomarkers With Chronic Plantar Heel Pain: A Case–Control Study

Rogers

Jones

Cook

et al. 2022

Arthritis Care & Research

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Objective. To determine associations between chronic plantar heel pain (CPHP) and imaging biomarkers derived from magnetic resonance imaging (MRI) and ultrasonography.Methods. We compared 218 participants with CPHP with 100 age-and sex-matched population controls. We assessed imaging biomarkers on MRI (calcaneal bone marrow lesions [BMLs], plantar fascia [PF] signal and thickness, spurs, and fat pad signal) and B-mode/power Doppler ultrasound (PF thickness, echogenicity, and vascularity). Covariate data collected included demographic characteristics, disease history, clinical measures, and physical activity by accelerometry. Data were analyzed using multivariable conditional logistic regression.Results. Plantar calcaneal BML size (mm 2 , odds ratio [OR] 1.03 [95% confidence interval (95% CI) 1.02-1.05]), larger plantar spurs (OR for spurs >5 mm 2.15 [95% CI 1.13-4.10]), PF signal (OR for signal penetrating >50% of the dorsoplantar width 12.12 [95% CI 5.36-27.42]), PF thickness (mm, OR for MRI 3.23 [95% CI 2.36-4.43] and ultrasound OR 3.78 [95% CI 2.69-5.32]), and echogenicity ] and focally hypoechoic OR 24.92 [95% CI 9.60-64.69]) were independently associated with CPHP. PF vascularity was uncommon, occurring exclusively in cases (cases with signal n = 47 [22%]). Combining imaging biomarkers into 1 model, plantar BMLs and PF imaging biomarkers, but not fat pad signal or heel spurs, were independently associated with CPHP.Conclusion. Calcaneal BMLs and PF imaging biomarkers are associated with CPHP. Further research is required to understand whether these different markers represent distinct phenotypes of heel pain, and if so, whether there are specific treatment implications.

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Diagnostic imaging for chronic plantar heel pain: a systematic review and meta‐analysis

Cited by 35 publications

References 0 publications

Plantar fascia softening in plantar fasciitis with normal B-mode sonography

Plantar fascia softening in plantar fasciitis with normal B-mode sonography

Effects of extracorporal shock wave therapy on symptomatic heel spurs: a correlation between clinical outcome and radiologic changes

Association of Calcaneal Bone Marrow Lesions and Plantar Fascia Imaging Biomarkers With Chronic Plantar Heel Pain: A Case–Control Study

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