Role of high-resolution ultrasound in guiding treatment of idiopathic plantar fasciitis with minimally invasive techniques.
OBJECTIVE
The aim of this study was to assess the reliability of peri-fascial oedema as a sonographic criterion for selecting the most appropriate treatment (ultrasound-guided corticosteroid injection or ultrasound-guided extracorporeal shock wave therapy) of idiopathic plantar fasciitis (IPF).


METHODS
Sixty-four patients with a clinical diagnosis of unilateral refractory IPF, treated conservatively for at least 8 weeks, were studied with high-resolution ultrasound (HRUS). Pain intensity was evaluated with a visual analogue scale (VAS). HRUS was used to confirm IPF and identify the presence of peri-fascial oedema. Patients with an HRUS diagnosis of IPF were grouped according to the presence (A) or absence (B) of peri-fascial oedema and then randomly allocated to treatment with corticosteroid injection (1) or extracorporeal shock wave therapy (2). Clinical and HRUS follow-up was performed 6 weeks after treatment.


RESULTS
HRUS confirmed IPF in 68,97% of patients and identified peri-fascial oedema in 53.33%. Clinical and sonographic improvements were observed in 87.5% and 37.5% of patients in subgroups A1 and A2, respectively, and in 35.71% and 92.85% of those in subgroups B1 and B2, respectively.


CONCLUSIONS
The presence of peri-fascial oedema may represent an effective criterion for guiding treatment decisions towards HRUS-guided corticosteroid injection.
Sorrentino
F
F
DIBIMEL, Sezione di Scienze Radiologiche, Università degli Studi di Palermo, Via del Vespro 127, 90127 Palermo, Italy. drdiving@yahoo.it
Iovane
A
A
Vetro
A
A
Vaccari
A
A
Mantia
R
R
Midiri
M
M
D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D012802:Sicily; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods; D018084:Ultrasonography, Interventional
D005938:Glucocorticoids