title: Sonographically guided corticosteroid injection for treatment of plantar fasciosis.
abstract: OBJECTIVE
  The purpose of this study was to prospectively investigate the effect of sonographically guided corticosteroid injection on the clinical and radiologic responses in patients with proximal plantar fasciosis.
  
  
  METHODS
  Thirty-one consecutive patients with unilateral plantar fasciosis were enrolled. A 4-cm 21-gauge needle was positioned in a caudocranial oblique manner, and the needle was withdrawn to the near edge of the fascia so that the solution dispersed around the edge. Two milliliters (20 mg/mL) of lignocaine/prilocaine, 1%, and 0.5 mL (20 mg) of methylprednisolone acetate solutions were injected separately. The plantar fascia and fat pad thickness, fascial echogenicity, and perifascial edema were assessed with a 10-5 MHz linear array transducer. The American Orthopedic Foot and Ankle Society midfoot scale was used to assess function, alignment, and pain. The initial radiologic and clinical measurements were compared with data obtained not less than 6 weeks after the injections.
  
  
  RESULTS
  A statistically significant decrease in the mean plantar fascia thickness was detected after treatment (P < .0001). There was no statistically significant difference in the plantar fascia echogenicity before and after treatment (P = .11). A statistically significant decrease was found for perifascial edema (P < .0001), and a statistically significant increase in American Orthopedic Foot and Ankle Society scores was detected (P = .0007). There was no decrease in fat pad thickness (P > .1). Plantar fascia rupture was detected in 1 patient.
  
  
  CONCLUSIONS
  Sonographically guided corticosteroid injection enables real-time imaging of the plantar fascia during needle insertion. A caudocranial oblique injection beneath the fascia may have an incremental value in the treatment response in patients with plantar fasciosis.
authors: Department of Radiology, Faculty of Medicine, Namık Kemal University, Tekirdağ, Turkey. arda_kayhan@yahoo.com
authors: Arda
authors: A
authors: Kayhan
authors: Nevzat Selim
authors: NS
authors: Gökay
authors: Rümeysa
authors: R
authors: Alpaslan
authors: Mehmet
authors: M
authors: Demirok
authors: İbrahim
authors: İ
authors: Yılmaz
authors: Alper
authors: A
authors: Gökçe
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D016009:Chi-Square Distribution; D036981:Fasciitis, Plantar / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010147:Pain Measurement; D056888:Patient Positioning; D011446:Prospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D005938:Glucocorticoids; D008775:Methylprednisolone