title: Anatomical detection of inflammatory changes associated with plantar warts by ultrasound.
abstract: BACKGROUND
  Plantar warts are common and pain is one of the main symptoms. The anatomical alterations associated with the primary lesion are unclear. Moreover, an adequate separation between the lesion and the surrounding tissue abnormalities could help to better manage this pathology and enable the provision of comprehensive information to physicians and patients.
  
  
  METHODS
  A color Doppler ultrasound examination was performed on 29 recurrent plantar warts and 10 healthy controls. The morphology and extension of the warts and surrounding soft tissue abnormalities are described. The diagnosis of a plantar wart was correlated with a standard histology in all cases. Statistical analysis was performed by the Student t test.
  
  
  RESULTS
  On ultrasound, all warts were recognizable, and sonographic signs of soft tissue inflammation were detected that were associated with the warts: in 79% (23/29) of the cases there was an increase in sublesional arterial blood flow in the dermis, 54% (16/29) had a plantar bursitis, and 52% (15/29) had a focal decrease in subcutaneous echogenicity. No signs of inflammation were seen in the unaffected controls.
  
  
  CONCLUSIONS
  Ultrasound can provide detailed anatomical data on warts and their inflammatory changes in the surrounding tissues. This noninvasive imaging technique may help to manage difficult cases.
authors.affiliation: Department of Radiology, Clinica Servet, Santiago, Chile. xwo @ tie.cl
authors.forename: Ximena
authors.initials: X
authors.lastname: Wortsman
authors.forename: Gregor B E
authors.initials: GB
authors.lastname: Jemec
authors.forename: Ivo
authors.initials: I
authors.lastname: Sazunic
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005533:Foot Dermatoses / Q000000981:diagnostic imaging*; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012867:Skin / Q000098:blood supply / Q000648:ultrastructure; D018615:Ultrasonography, Doppler, Color; D014860:Warts / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult