High frequency ultrasonographic findings in plantar fasciitis and assessment of local steroid injection.
OBJECTIVE
To investigate the value of ultrasonography in the diagnosis of plantar fasciitis and changes in plantar fascia following ultrasound guided local steroid injection.


METHODS
Twenty patients with a clinical diagnosis of plantar fasciitis and 20 healthy subjects were studied prospectively. Ultrasound examination was performed using an ATL Apogee 800 and linear array 11 MHz transducer. The affected heel was injected with 15 mg triamcinolone hexacetonide and 2 ml of 2% lidocaine. Ultrasound examination was performed at time of clinical evaluation, again immediately after injection, and at 1, 6, and 30 weeks later. The thickness, echogenicity, and marginal appearance of plantar fascia were measured.


RESULTS
Ultrasonographic measurement of plantar fascia showed a significant increase in symptomatic heels (range 4.8-6.5, mean 5.8 +/- 2.06 mm) compared with healthy subjects (range 1.8-3.4, mean 2.4 +/- 0.64 mm) (p < 0.001). A significant decrease in the thickness of plantar fascia was observed 1 week after local steroid injection (range 2.1-3.5, mean 2.3 +/- 0.91 mm). Complete relief of symptoms and signs was further observed at 6 and 30 weeks.


CONCLUSIONS
Ultrasonographic examination of plantar fascia is easy and quick to perform. Ultrasound procedure should be considered early in diagnosis and management of heel pain. Ultrasound guided local steroid injection proved safe and effective in the treatment of plantar fasciitis.
Kamel
M
M
Dr. Fakhry-Al Muhawis Hospital, Alkhobar, Saudi Arabia. mkamel56@hotmail.com
Kotob
H
H
D000328:Adult; D000368:Aged; D005208:Fasciitis / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging*; D005534:Foot Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013256:Steroids / Q000008:administration & dosage*; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods*
D013256:Steroids