Diagnosis and treatment of heel pain in chronic inflammatory arthritis using ultrasound.
The authors examined the role of ultrasound (US) in diagnosis and management of heel pain in chronic inflammatory arthritis. Nineteen patients underwent US examination. Eight patients (2 with previously unsuccessful nonguided injections), had 11 US-guided corticosteroid injections for treatment of retrocalcaneal bursitis (n = 6), plantar fasciitis (n = 3), and posterior tibial tenosynovitis (n = 2). US-demonstrated Achilles tendon rupture (n = 2), Achilles tendinitis (n = 8), posterior tibial tenosynovitis (n = 6), peroneus longus tenosynovitis (n = 2), retrocalcaneal bursitis (n = 13), and plantar fasciitis (n = 4). Loss of smooth bone contour (n = 13) correlated with bone erosions on plain radiographs in all but one case. Ten of 11 guided injections resulted in full resolution of heel pain. The diverse causes of heel pain are highlighted, and the ability of US to provide information with management implications is confirmed. US-guided corticosteroid injection is beneficial, especially after failure of nonguided injection.
Cunnane
G
G
University Department of Rheumatology, University College Dublin, St. Vincent's Hospital, Ireland.
Brophy
D P
DP
Gibney
R G
RG
FitzGerald
O
O
D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000293:injuries; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D001862:Bone Resorption / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D002062:Bursitis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D005208:Fasciitis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D006365:Heel / Q000000981:diagnostic imaging*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D012421:Rupture / Q000150:complications / Q000628:therapy; D052256:Tendinopathy / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D016896:Treatment Outcome; D014463:Ultrasonography
D000305:Adrenal Cortex Hormones