High‐resolution ultrasonographic diagnosis of plantar fasciitis: a correlation of ultrasound and magnetic resonance imaging

Abstract

Aim and Method: In a prospective study of nine men and eight women with suspected unilateral or bilateral plantar fasciitis, 23 symptomatic heels were examined by both high‐resolution ultrasound and a preplanned limited sagittal magnetic resonance imaging (MRI) protocol to assess the different signs. Eleven healthy volunteers (22 heels) acted as controls. Results: The plantar fascia was thickened in symptomatic feet. The thickness of the plantar fascia in symptomatic feet was (3.0–7.0 mm; 4.9 ± 1.3) measured by ultrasound which was significantly thicker than in the control group (1.1–2.4 mm; 1.7 ± 0.06); P < 0.05. Other sonographic signs used for the diagnosis of plantar fasciitis in the study were compared to MRI findings. The diagnostic accuracy was 69.5% for abnormal focal echogenicity within the plantar fascia, 60.8% for edema around the plantar fascia, 78.2% for perifascial edema, 69.5% for rupture of the plantar fascia and the lowest diagnostic accuracy of ultrasound was in detection of associated calcaneal spur (56.5%). The findings were tabulated and discussed in relation to other literature. Conclusion: It was concluded that the diagnostic accuracy of ultrasound is comparable to that of MRI in the diagnosis of plantar fasciitis and it could be the straightforward initial imaging modality to confirm clinically suspected plantar fasciitis. MRI may be reserved for cases where a diagnosis of plantar fasciitis does not satisfactorily explain the clinical presentation and when complex pathology is suspected.

Potential for foot dysfunction and plantar fasciitis according to the shape of the foot arch in young adults

“… Karabay et al (2007) reported that the average thickness of the plantar fascia of patients with plantar fasciitis was approximately 4.8 mm. Abdel-Wahab et al (2008) reported a similar result, saying that the plantar fascia thickness was about 4.9 mm among patients with plantar fasciitis. Other previous studies reported the average fascia thickness of patients with plantar fasciitis to be around 5.2–5.9 mm ( Cardinal et al, 1996 ; Gibbon and Long, 1997 ; Kane et al, 2001 ).…”

“…For the ultrasonic image, the subject was in a prone position and made a knee extension with 90° flexion of the ankle. After vertically scanning the proximal interior where the plantar fascia is attached to the surface of the calcaneus, we measured the thickness of the plantar fascia on the node area of the calcaneus, where the plantar fascia originates ( Abdel-Wahab et al, 2008 ; Radwan et al, 2016 ) ( Fig. 1 ).…”

Higher body mass index is associated with plantar fasciopathy/‘plantar fasciitis’: systematic review and meta-analysis of various clinical and imaging risk factors

“…Twenty-one studies described the association between PFT and PF,27 29 32 34 39 40 43 44 47 49 53 59–68 nine of which applied matching for possible confounding factors such as age, gender and body weight (see online supplementary file 2) 34 40 44 47 49 60 62 63 66…”

“…Pooled data for all imaging techniques from 19 studies showed that people with PF had an average 2.32 mm (95% CI 1.86 to 2.79) thicker plantar fascia compared to control participants (MD of (figure 5). 27 29 32 34 39 40 43 44 49 59–68 Subgroup analyses for the separate imaging techniques showed a MD of 2.20 (95% CI 1.68 to 2.72) for US, 3.36 (95% CI 1.81 to 4.90) for MRI and 2.40 (95% CI 1.88 to 2.92) for X-ray. Similar trends were seen in the two studies in which pooling was not possible 47 53.…”

Effectiveness of Dry Needling for the Management of Plantar Fasciitis: A Review Study

“…PF is a multifactorial and self-limiting disorder that several factors are involved in its onset [22]. Common risk factors usually reported in the literature include aging; high body mass index; anatomical problems such as pes planus, pes cavus foot types, excessive tibial torsion, or leg length discrepancy; tightness in gastrocnemius and soleus muscles; weakness of intrinsic foot muscles; prolonged standing and running activities; using improper shoe fit and wear; previous injury and running variables such as surface, speed, frequency and distance per week [20,[23][24][25][26][27][28][29].…”